title: Initial evaluation of breast cancer using Tc-99m sestamibi scintimammography.
abstract: OBJECTIVE
  Aim of the study was to elaborate on the diagnostic role of Tc-99m sestamibi scintimammography (SMM) in the initial diagnosis of breast cancer, partially in comparison to MRI. The study presents an update of previously published data.
  
  
  METHODS
  Out of a total of 464 scintimammograms findings of 252 studies were correlated with the histopathologic outcome. A subgroup of 68 patients with indeterminate preliminary diagnosis underwent additional MRI. SMM and MRI findings were correlated to the final hisopathological outcome.
  
  
  RESULTS
  Overall sensitivity and specificity for SMM were 84 and 85%, respectively. Depending on tumor size sensitivity ranged from 60% for stage pT1a,b carcinomas to 94% stage pT1c or higher. In the subgroup with indeterminate preliminary diagnosis sensitivity of SMM decreased to 76% which was lower as compared to MRI (84%). Specificity of SMM was 86% in this subgroup which was evidently higher as compared to MRI (51%).
  
  
  CONCLUSIONS
  SMM has severe limitations in the diagnosis of small carcinoma and therefore should not be used for breast cancer screening. SMM can be used to further evaluate indeterminate or probably benign mammographic findings, especially when conventional mammography is inconclusive due to dense breast tissue.
authors.affiliation: Department of Nuclear Medicine, Ludwig-Maximilians-University, Ziemssenstreet 1, 80336 Munich, Germany. tiling@nuk.med.uni-muenchen.de
authors.forename: Reinhold
authors.initials: R
authors.lastname: Tiling
authors.forename: Mareike
authors.initials: M
authors.lastname: Kessler
authors.forename: Michael
authors.initials: M
authors.lastname: Untch
authors.forename: Harald
authors.initials: H
authors.lastname: Sommer
authors.forename: Rainer
authors.initials: R
authors.lastname: Linke
authors.forename: Klaus
authors.initials: K
authors.lastname: Hahn
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D019786:Gadolinium DTPA