Abstract
Purpose.To assess the value of 99m-Tc-tetrofosmin (tetrofosmin) scintigraphy in patients with palpable and non-palpable breast lesions.
Patients and methods.Prospective, blinded trial. One hundred and fifty-nine consecutive patients with 163 breast lesions detected by clinical examination and mammography were included. Tetrofosmin scintigraphy of the breast was performed additionally to the regular diagnostic procedure. Using histologic assessment as the golden standard, sensitivity, specificity, positive and negative predictive value for tetrofosmin scintigraphy of the breast were assessed.
Results.Overall sensitivity and specificity were 82% and 84%. The sensitivity for palpable tumors (65%) was 93% compared to 62% for non-palpable breast lesions. Malignant lesions were nearly twice as big as benign lesions (31.5 mm± 2.4 vs. 16.9 mm ± 2.4). Specificity, positive and negative predictive value (84%, 89%, and 66%) did not differ significantly in palpable versus non-palpable tumors. Of malignant tumors 18% were found false negative by tetrofosmin scintigraphy.
Conclusion.The results suggest that tetrofosmin scintigraphy is a valuable tool for the evaluation of palpable breast cancer. In patients with non-palpable tumors, tetrofosmin scintigraphy may not add to the work-up of patients with breast cancer due to a low sensitivity rate.
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References
Center for Disease Control: Breast cancer incidence and mortality - United States, 1992. MMWR 45: 835–837, 1996
Kerlikowske K, Grady D, Barclay J, Sickles EA, Ernster V: Effect of age, breast density, and family history on the sensitivity of first screening mammography. JAMA 276: 33–38, 1996
Mansi L, Rambaldi PF, Procaccini E, Gregorio FD, Laprovitera A, Pecori B, Vecchio WD: Scintimammography with technetium-99m tetrofosmin in the diagnosis of breast cancer and lymph node metastases. Eur J Nucl Med 23: 932–939, 1996
Rambaldi PF, Mansi L, Procaccini E, Di-Gregorio F, Del-Vecchio E: Breast cancer detection with Tc-99m tetrofosmin. Clin Nucl Med 20: 703–705, 1995
Lind P, Gallowitsch HJ, Kogler D, Kresnik E, Mikosch P, Gomez I: Tc-99m-tetrofosmin scintimammography: a prospective study in primary breast lesions. Nuklearmedizin 35: 225–229, 1996
Basoglu T, Sahin M, Coskun C, Koparan A, Bernay I, Erkan L: Technetium-99m-tetrofosmin uptake in malignant lung tumours. Eur J Nucl Med 22: 687–689, 1995
Berghammer P, Obwegeser R, Müllauer-Ertl S, Karanikas G, Wiltschke C, Kubista E, Sinzinger H, Zielinski CC: 99m-Tctetrofosmin scintigraphy and breast cancer. Gynecol Oncol 73: 87–90, 1999
Schillaci O, Scopinaro F, Danieli R, Picardi V, Tavolaro R, Cannas P, Colella AC: Scintimammography with technetium-99m tetrofosmin in suspected breast cancer. Anticancer Res 17: 1623–1626, 1997
Reintgen D, Berman C, Cox C, Baekey P, Nicosia S, Greenberg H, Bush C, Lyman GH, Clark RA: The anatomy of missed breast cancers. Surg Oncol 2: 65–75, 1993
Fenlon HM, Phelan NC, O'Sullivan P, Tierney S, Gorey T, Ennis JT: Benign versus malignant brewst disease: comparison of contrast-enhanced MR imaging and Tc-99m-tetrofosmin scintimammography. Radiology 205: 214–220, 1997
Helbich T, Becherer A, Trattnig S, Leitha T, Kelkar P, Seifert M, Gnant M, Staudenherz A, Rudas M, Wolf G, Mostbeck GH: Differentiation of benign and malignant breast lesions: MR-imaging versus Tc-99m-sestamibi scintimammography. Radiology 202: 421–429, 1997
Vieira MR, Weinholtz JH: Technetium-99m tetrofosmin scintigraphy in the diagnosis of breast cancer. Eur J Surg Oncol 22: 331–334, 1996
Mekhmandarov S, Sandbank J, Cohen M, Lelcuk S, Lubin E: Technetium-99m-MIBI scintimammography in palpable and non-palpable breast lesions. J Nucl Med 39: 86–91, 1998
Cimitan M, Volpe R, Candiani E, Gusso G, Ruffo R, Borsatti E, Massarut S, Rossi C, Morassut S, Carbone A: The use of thallium-201 in the preoperative detection of breast cancer: an adjunct to mammography and ultrasonography. Eur J Nucl Med 22: 1110–1117, 1995
Vural G, Atasever T, Özdemir A, Öznur I, Karabacak NI, Gökcora N, Isik S, Ñnlü M: TI-201-scintigraphy in the evaluation of palpable and non-palpable breast lesions: Correlation with mammography and ultrasosnography. Nuklearmedizin 36: 282–288, 1997
Lam WW, Yang WT, Chan YL, Stewart IE, King W, Metreweli C: Role of MIBI breast scintigraphy in evaluation of palpable breast lesions. Br J Radiol 69: 1152–1158, 1996
Buscombe JR, Cwikla JB, Thakrar DS, Hilson AJW: Scintigraphic imaging of breast cancer: a review. Nucl Med Comm 18: 698–709, 1997
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Obwegeser, R., Berghammer, P., Muellauer-Ertl, S. et al. 99m-Tc-tetrofosmin scintigraphy for the evaluation of suspicious palpable and non-palpable breast lesions. Breast Cancer Res Treat 62, 253–258 (2000). https://doi.org/10.1023/A:1006442622417
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DOI: https://doi.org/10.1023/A:1006442622417