[Scintimammography with 99mTC-MIBI in the clinical practice: repercussion on the clinical management of the patient].
OBJECTIVE
Establish the usefulness of scintimammography (SM) in day-to-day clinical practice.


METHODS
We have evaluated 308 SM consecutively performed in our Department. The diagnosis was established by way of biopsy or clinical and mammography follow-up (minimum 18 months). In all cases we evaluated the kind of lesions (palpable or non-palpable) and their degree of suspicion of malignancy in the mammography (BIRADS). We determined the number of fine-needle aspiration cytology (FNAC) or biopsies performed in dependence of kind of lesions, mammography and SM results.


RESULTS
Final diagnosis was cancer in 18 % of the patients, and 71 % of the lesions were non palpable. Negative predictive value (NPV) of SM was 96 %. Pathological diagnosis was performed in 100 % of lesions with SM+ and 16 % of lesions with SM-. According to the kind of lesion, FNAC and/or biopsy was performed in 62 % of palpable lesions and in 20 % of non-palpable lesions; and according to the mammography in 21 % of lesions BIRADS I-II, 14 % in BIRADS III, 70 % in BIRADS IV and 100 % in BIRADS V. The number of FNAC and/or biopsies performed is significantly higher in all cases when SM is positive (p > 0,001), excepting in BIRADS V lesions.


CONCLUSIONS
In day-to-day clinical practice SM is generally performed in low prevalence of breast cancer population, in the evaluation of non-palpable lesions with a low suspicion of malignancy. SM has a high NPV, increase the diagnostic accuracy of the mammography and has repercussion on patient management, except in BIRADS V lesions.
Prats
E
E
Servicio de Medicina Nuclear, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain. eprats@mixmail.com
Razola
P
P
Sainz
J M
JM
Tardín
L
L
Andrés
A
A
Abós
M D
MD
García
F
F
Fernández
J
J
Villavieja
L
L
Banzo
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D001940:Breast / Q000000981:diagnostic imaging* / Q000473:pathology; D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000628:therapy; D019468:Disease Management; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010173:Palpation; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017256:Technetium Tc 99m Sestamibi
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi