Scintimammography with dedicated breast camera detects and localizes occult carcinoma.

Abstract

This study assessed the utility of scintimammography using a standard gamma-camera and a dedicated breast camera as an adjuvant to mammography and clinical examination. The study population comprised 37 patients with dense breasts and a family or personal history of breast cancer. The subjects had no suggestive clinical or mammographic findings. After intravenous administration of (99m)Tc-sestamibi, the patients were imaged using a conventional gamma-camera and a dedicated breast camera that allowed breast compression during image acquisition. Images were interpreted independently by 2 reviewers. All patients with positive scintimammography findings underwent biopsy. Dedicated breast camera results were positive in 13.5% (5/37) of patients. Biopsy of these 5 patients yielded 3 carcinomas: an infiltrating lobular carcinoma, a ductal carcinoma in situ, and an infiltrating tubular carcinoma. These 3 carcinomas were undetectable by clinical breast examination or mammography, even on retrospective review. Only one of these, the tubular carcinoma, was readily detectable by the standard gamma-camera. Scintimammography using a dedicated breast camera may augment mammography and clinical breast examination for the subset of women who have dense breast tissue and are at high risk of breast cancer.