title: Methodological aspects of99mTc-sestamibi guided biopsy in breast cancer.
abstract: OBJECTIVE
  This review aims to discuss the methodological aspects of dedicated molecular breast imaging (MBI) using99mTc-sestamibi as radiotracer to guide biopsy of occult or unclear breast lesions on mammography (MG) and ultrasound (US) that are suspicious on MBI (BI-RADS criteria 4 and 5), including its advantages, limitations and future clinical applications.
  
  
  METHODS
  Literature search was performed using the PubMed/MEDLINE database and "99mTc-sestamibi", "biopsy" and "breast cancer" as keywords. The search was restricted to English language.
  
  
  RESULTS
  There are few studies on99mTc-sestamibi guided biopsy methods; to our knowledge, no full studies have yet been reported on clinical validation of this new biopsy procedure. This review describes technical aspects of99mTc-sestamibi guided biopsy and discusses the advantages and limitations of this procedure in comparison with MG, US and MRI-guided biopsy.
  
  
  CONCLUSIONS
  MBI-guided biopsy appears to be a complementary modality and is principally indicated in the case of occult or unclear breast lesions on MG/US, that are suspicious on MBI. The future indication is in targeted biopsies in patients with large heterogeneous tumours. Further studies are needed to define the accuracy of this biopsy procedure.
authors.affiliation: Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Collarino
authors.affiliation: Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands ; Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands ; Department of Nuclear Medicine, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
authors.forename: R A
authors.initials: RA
authors.lastname: Valdés Olmos
authors.affiliation: Department of Nuclear Medicine, Alrijne Ziekenhuis, Simon Smitweg 1, 2353 GA Leiderdorp, The Netherlands.
authors.forename: A F
authors.initials: AF
authors.lastname: van der Hoeven
authors.affiliation: Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands ; Department of Nuclear Medicine, Alrijne Ziekenhuis, Simon Smitweg 1, 2353 GA Leiderdorp, The Netherlands.
authors.forename: L M
authors.identifier: 0000-0002-6879-5554
authors.initials: LM
authors.lastname: Pereira Arias-Bouda
keywords: 99mTc-sestamibi; Breast cancer; Breast-specific γ-imaging; Molecular breast Imaging; Radioguided-biopsy