Detection of bilateral multifocal breast cancer using Tc-99m sestamibi imaging. The role of delayed imaging.
OBJECTIVE
Early determination that breast cancer is bilateral and multifocal can change therapy strategy and, subsequently, mortality and morbidity rates. The authors present a case with bilateral, multifocal breast cancer detected only by Tc-99m sestamibi imaging.


METHODS
Early and delayed Tc-99m sestamibi imaging and dynamic MRI were performed in a patient with a right-sided lesion shown on mammography.


RESULTS
Although early Tc-99m sestamibi imaging detected bilateral breast cancer foci, both dynamic MRI and mammography missed the lesion in the left breast. Additional lesions seen on delayed Tc-99m sestamibi images of the left breast, which were initially thought to be benign, completely disappeared after concomitant chemotherapy and radiotherapy, suggesting multifocal malignant lesions in the left breast.


CONCLUSIONS
This case suggests that Tc-99m sestamibi may be useful for detecting bilateral cancer, and delayed imaging may give additional information regarding the possible multifocal nature of the disease.
Derebek
E
E
Department of Nuclear Medicine, Dokuz Eylul University, School of Medicine, Izmir, Turkey.
Balci
P
P
Alanyali
H
H
Kocdor
M A
MA
Capa
G
G
Gorken
I B
IB
Degirmenci
B
B
Alakavuklar
M
M
Canda
T
T
Durak
H
H
D001943:Breast Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000000981:diagnostic imaging*; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi