Detection of malignant breast tumours in dense breast tissue: results of99mTc-tetrofosmin scintimammography related to surgery

Abstract

AimsTo assess the contribution of99mTechnetium tetrofosmin (99mTc-TF) scintimammography for staging of breast lesions in patients with a suspicious or non-diagnostic mammogram to reduce unnecessary surgical procedures in future.MethodsFifty patients with suspicious physical examinations and/or mammography underwent99mTc-TF breast imaging.ResultsScintimammography with99mTc-TF was positive in 37 patients (36 true positive, one false positive) and negative in 13 patients (12 true negative, one false negative). The detection of a malignant tumour by99mTc-TF was independent of the density of the breast tissue. In 33 patients with a malignant breast tumour99mTc-TF was diagnostic with respect to axillary status, but in four out of 19 patients with a histologically positive axillary lymph node status, tumour involvement remained undetected by scintigraphy. Moreover, in four patients, scintimammography revealed an additional discrete area of increased99mTc-TF uptake, which proved to be second primary breast cancers.Conclusions99mTc-TF scintimammography appears to be an accurate diagnostic test in patients with a symptomatic breast lesion and a non-diagnostic mammogram, also in those patients with dense breast tissue. This procedure may also have potential for the detection of second primary breast cancers in an early stage.