title: Clinical utility of 99mTc-Sestamibi scintimammography in the management of equivocal breast lesions.
abstract: The aim of this study was to assess the utility of 99mTc-sestamibi scintimammography (SM) in patients with suspected primary or recurrent breast cancer. Forty-four (44) breast lesions (17 with suspected recurrence of disease) in 40 patients were included into the study. In these patients, the results of conventional diagnostic methods were equivocal or inconclusive. Twenty-one (21) lesions were palpable and 23 lesions were not. Histological examinations performed during the follow-up revealed malignancy in 24 specimens. SM correctly identified 21 of them, as well as 12 true negatives. There were 8 false-positive studies; therefore, the sensitivity of SM was 87.5%, specificity was 60%, positive predictive value (PPV) was 72.4%, and the negative predictive value (NPV) was 80%. The sensitivity in palpable lesions was 100%; three (3) false negatives, 1 recurrence, and 2 cancers, all of them nonpalpable. In conclusion, SM is useful in equivocal palpable lesions for resolving diagnostic uncertainty after conventional examination, and can limit the number of surgical interventions for benign disease. However, its use in nonpalpable tumors is not recommended.
authors.affiliation: Division of Nuclear Medicine, European Institute of Oncology, Milan, Italy. concetta.de-cicco@ieo.it
authors.forename: Concetta
authors.initials: C
authors.lastname: De Cicco
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Trifirò
authors.forename: Silvia
authors.initials: S
authors.lastname: Baio
authors.forename: Maribel Lopera
authors.initials: ML
authors.lastname: Sierra
authors.forename: Maria
authors.initials: M
authors.lastname: Pizzamiglio
authors.forename: Enrico
authors.initials: E
authors.lastname: Cassano
authors.forename: Gennaro
authors.initials: G
authors.lastname: Prisco
authors.forename: Giovanna
authors.initials: G
authors.lastname: Gatti
authors.forename: Viviana
authors.initials: V
authors.lastname: Galimberti
authors.forename: Alberto
authors.initials: A
authors.lastname: Luini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Paganelli
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000628:therapy*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012008:Recurrence; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi / Q000627:therapeutic use*
chemical_list: D017256:Technetium Tc 99m Sestamibi