title: Can positron emission mammography help to identify clinically significant breast cancer in women with suspicious calcifications on mammography?
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of positron emission mammography (PEM) for identifying malignant lesions in patients with suspicious microcalcifications detected on mammography.
  
  
  METHODS
  A prospective, single-centre study that evaluated 40 patients with suspicious calcifications at mammography and indication for percutaneous or surgical biopsy, with mean age of 56.4 years (range: 28-81 years). Patients who agreed to participate in the study underwent PEM with 18F-fluorodeoxyglucose before the final histological evaluation. PEM findings were compared with mammography and histological findings.
  
  
  RESULTS
  Most calcifications (n = 34; 85.0 %) were classified as BIRADS 4. On histology, there were 25 (62.5 %) benign and 15 (37.5 %) malignant lesions, including 11 (27.5 %) ductal carcinoma in situ (DCIS) and 4 (10 %) invasive carcinomas. On subjective analysis, PEM was positive in 15 cases (37.5 %) and most of these cases (n = 14; 93.3 %) were confirmed as malignant on histology. There was one false-positive result, which corresponded to a fibroadenoma, and one false negative, which corresponded to an intermediate-grade DCIS. PEM had a sensitivity of 93.3 %, specificity of 96.0 % and accuracy of 95 %.
  
  
  CONCLUSIONS
  PEM was able to identify all invasive carcinomas and high-grade DCIS (nuclear grade 3) in the presented sample, suggesting that this method may be useful for further evaluation of patients with suspected microcalcifications.
  
  
  CONCLUSIONS
  • Many patients with suspicious microcalcifications at mammography have benign results at biopsy. • PEM may help to identify invasive carcinomas and high-grade DCIS. • Management of patients with suspicious calcifications can be improved.
authors: A C Camargo Cancer Center-Department of Imaging, R. Prof. Antônio Prudente, 211, São Paulo, SP, Brazil, 01509-010. almirgvb@yahoo.com.br.
authors: Almir G V
authors: AG
authors: Bitencourt
authors: A C Camargo Cancer Center-Department of Imaging, R. Prof. Antônio Prudente, 211, São Paulo, SP, Brazil, 01509-010.
authors: Eduardo N P
authors: EN
authors: Lima
authors: A C Camargo Cancer Center-Department of Imaging, R. Prof. Antônio Prudente, 211, São Paulo, SP, Brazil, 01509-010.
authors: Bruna R C
authors: BR
authors: Macedo
authors: A C Camargo Cancer Center-Department of Imaging, R. Prof. Antônio Prudente, 211, São Paulo, SP, Brazil, 01509-010.
authors: Jorge L F A
authors: JL
authors: Conrado
authors: A C Camargo Cancer Center-Department of Imaging, R. Prof. Antônio Prudente, 211, São Paulo, SP, Brazil, 01509-010.
authors: Elvira F
authors: EF
authors: Marques
authors: A C Camargo Cancer Center-Department of Imaging, R. Prof. Antônio Prudente, 211, São Paulo, SP, Brazil, 01509-010.
authors: Rubens
authors: R
authors: Chojniak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000000981:diagnostic imaging*; D055088:Early Detection of Cancer; D005260:Female; D018226:Fibroadenoma / Q000000981:diagnostic imaging / Q000473:pathology; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Breast neoplasms; Carcinoma ductal in situ; Fluorodeoxyglucose F18; Mammography; Positron emission tomography