title: Evaluation of molecular breast imaging in women undergoing myocardial perfusion imaging with Tc-99m sestamibi.
abstract: BACKGROUND
  Our objective was to explore the potential benefits of molecular breast imaging (MBI) as a screening technique in women undergoing stress myocardial perfusion studies.
  
  
  METHODS
  MBI was offered to women receiving Tc-99m sestamibi injection for myocardial perfusion stress testing. During the required waiting period after stress isotope injection, MBI was performed using a dedicated breast imaging gamma camera system. MBI examinations were interpreted by breast radiologists, with review of a recent mammogram in cases with positive MBI.
  
  
  RESULTS
  Of 322 women enrolled, 313 completed MBI, comprising 5 with known breast cancer, 2 with known high-risk benign breast lesions, and 306 who were asymptomatic for breast disease with a recent negative mammogram. Analysis was limited to the 306 patients with no known breast disease. MBI was positive in 22 of 306, giving a recall rate of 7.2% (95% confidence interval [CI] 4.8-10.6]. MBI detected 4 new cancers, resulting in a supplemental diagnostic yield of 13.1/1000 women screened (95% CI 5.1-33.2). The number of cancers diagnosed per abnormal MBI examinations (PPV(1)) was 18% (4 of 22) (95% CI 7.3-38.5), and the number diagnosed per MBI-prompted biopsies (PPV(3)) was 44% (4 of 9) (95% CI 18.9-73.3).
  
  
  CONCLUSIONS
  The addition of MBI to clinically indicated stress myocardial perfusion imaging studies in women results in a high diagnostic yield of newly detected breast cancers while generating a low rate of additional unnecessary workup.
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Carrie B
authors.initials: CB
authors.lastname: Hruska
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Rhodes
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Collins
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Tortorelli
authors.forename: J Wells
authors.initials: JW
authors.lastname: Askew
authors.forename: Michael K
authors.initials: MK
authors.lastname: O'Connor
mesh_terms: D000328:Adult; D001706:Biopsy; D001940:Breast / Q000000981:diagnostic imaging* / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D019275:Radiopharmaceuticals; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi