title: Clinical utility of breast-specific gamma imaging for evaluating disease extent in the newly diagnosed breast cancer patient.
abstract: BACKGROUND
  Breast-specific gamma imaging (BSGI) is a functional imaging modality that has comparable sensitivity but superior specificity compared with magnetic resonance imaging, yielding fewer false-positive results and thereby improving clinical management of the newly diagnosed breast cancer patient.
  
  
  METHODS
  A retrospective review was performed from 2 community-based breast imaging centers of newly diagnosed breast cancer patients in whom BSGI was performed as part of the imaging work-up.
  
  
  RESULTS
  A total of 138 patients (69 invasive ductal carcinoma, 20 invasive lobular carcinoma, 32 ductal carcinoma in situ, and 17 mixtures of invasive ductal carcinoma, invasive lobular carcinoma, or ductal carcinoma in situ and other) were reviewed. Twenty-five patients (18.1%) had a positive BSGI study at a site remote from their known cancer or more extensive disease than detected from previous imaging. Fifteen patients (10.9%) were positive for a synchronous or more extensive malignancy in the same or contralateral breast. Five patients had benign findings on pathology, 5 benign on ultrasound follow-up (false-positive rate, 7.2%). Findings converted 7 patients to mastectomy, 1 patient to neoadjuvant chemotherapy, and 7 patients were found to have previously undetected contralateral cancer. The positive predictive value for BSGI was 92.9%.
  
  
  CONCLUSIONS
  BSGI detected additional or more extensive malignancy in the same or contralateral breast in 10.9% of newly diagnosed breast cancer patients. Only 7.2% incurred an additional work-up. BSGI provides accurate evaluation of remaining breast tissue in newly diagnosed breast cancer patients with few false-positive readings.
authors.affiliation: Oregon Health and Science University, Portland, OR, USA.
authors.forename: Minhao
authors.initials: M
authors.lastname: Zhou
authors.forename: Nathalie
authors.initials: N
authors.lastname: Johnson
authors.forename: Sam
authors.initials: S
authors.lastname: Gruner
authors.forename: G W
authors.initials: GW
authors.lastname: Ecklund
authors.forename: Paul
authors.initials: P
authors.lastname: Meunier
authors.forename: Sally
authors.initials: S
authors.lastname: Bryn
authors.forename: Margie
authors.initials: M
authors.lastname: Glissmeyer
authors.forename: Kari
authors.initials: K
authors.lastname: Steinbock
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D005720:Gamma Rays; D006801:Humans; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi