title: Supplemental Breast Cancer Screening With Molecular Breast Imaging for Women With Dense Breast Tissue.
abstract: OBJECTIVE
  Molecular breast imaging was implemented in routine clinical practice at a large community-based breast imaging center. The aim of this study was to retrospectively assess the clinical performance of molecular breast imaging as a supplementary screening tool for women with dense breast tissue.
  
  
  METHODS
  Women with dense breasts and negative mammography results who subsequently underwent screening with 300 MBq (8 mCi) (99m)Tc-sestamibi molecular breast imaging were retrospectively analyzed. Outcome measures included cancer detection rate, recall rate, biopsy rate, and positive predictive values (PPVs).
  
  
  RESULTS
  Molecular breast imaging screening of 1696 women in this study resulted in the detection of 13 mammographically occult malignancies, of which 11 were invasive, one was node positive, and one had unknown node positivity. The lesion size ranged from 0.6 to 2.4 cm, with a mean of 1.1 cm. The incremental cancer detection rate was 7.7‰ (95% CI, 4.5-13.1‰), the recall rate was 8.4% (95% CI, 7.2-9.8%), and the biopsy rate was 3.7% (95% CI, 2.9%-4.7%). The PPV for recall (PPV 1) was 9.1% (95% CI, 5.4-15.0%), and the PPV for biopsy (PPV 3) was 19.4% (95% CI, 11.4-30.9%).
  
  
  CONCLUSIONS
  When incorporated into a community-based clinical practice environment, molecular breast imaging yielded a high incremental cancer detection rate of 7.7‰ at an acceptable radiation dose. These results show the utility of molecular breast imaging as a supplementary screening tool to mammography for women with dense breasts.
authors.affiliation: 1 Department of Radiology, ProMedica Breast Care, 2121 Hughes Dr, 1st Fl, Toledo, OH 43606.
authors.forename: Robin B
authors.initials: RB
authors.lastname: Shermis
authors.affiliation: 1 Department of Radiology, ProMedica Breast Care, 2121 Hughes Dr, 1st Fl, Toledo, OH 43606.
authors.forename: Keith D
authors.initials: KD
authors.lastname: Wilson
authors.affiliation: 1 Department of Radiology, ProMedica Breast Care, 2121 Hughes Dr, 1st Fl, Toledo, OH 43606.
authors.forename: Malcolm T
authors.initials: MT
authors.lastname: Doyle
authors.affiliation: 1 Department of Radiology, ProMedica Breast Care, 2121 Hughes Dr, 1st Fl, Toledo, OH 43606.
authors.forename: Tamara S
authors.initials: TS
authors.lastname: Martin
authors.affiliation: 1 Department of Radiology, ProMedica Breast Care, 2121 Hughes Dr, 1st Fl, Toledo, OH 43606.
authors.forename: Dawn
authors.initials: D
authors.lastname: Merryman
authors.affiliation: 2 Gamma Medica Inc., Salem, NH.
authors.forename: Haris
authors.initials: H
authors.lastname: Kudrolli
authors.affiliation: 3 Bay Imaging Consultants, Walnut Creek, CA.|4 Alta Bates Summit Medical Center, Oakland, CA.|5 Department of Radiology, University of California San Diego, San Diego, CA.
authors.forename: R James
authors.initials: RJ
authors.lastname: Brenner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D000071060:Breast Density; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D057054:Molecular Imaging; D011829:Radiation Dosage; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi
keywords: adjunct breast screening; dense breast screening; molecular breast imaging