Abstract
Objective: The study in this part was to evaluate the diagnostic value of Breast Specific Gamma Imaging (BSGI) by semi-quantitative method for detection of breast cancer.
 Methods: 400 patients with indeterminate breast tumors that underwent BSGI were enrolled in this study. All included lesions were confirmed by postoperative pathology. BSGI evaluation was based on the visual interpretation and semi-quantitative parameters of the higher tumor to non-lesion (T/N) value of CC and MLO. Compared with pathological results, the optimal visual analysis and the value of T/N were calculated through ROC curve analysis. Independent t-test and Pearson linear correlation were applied for statistical analysis.
 Results: Tumor to non-lesion (T/N) ratio was available for 279 out of 400 patients. This population comprised 203 patients with malignant and 74 patients with benign lesion. ROC analysis showed critical value of T/N= 1.91, AUC is 0.83 (standard error=0.014, 95% confidence interval); BSGI sensitivity is 83.71% and specificity is 76%. T/N ratio for invasive and non-invasive cancers are 2.70± 0.88, and 2.09±0.44 respectively; the difference between two have statistical significance (t=3.32, P=0.001). Infiltrating ductal carcinoma (IDC) grade I, grade II, and grade III have T/N ratio of 2.33±0.94, 2.38±0.80, 2.89±0.89 respectively. The T/N differences between grade I and grade II have no statistical significance (t=0.12, P=0.89). The T/N differences between grade I and grade III have no statistical significance (t=1.56, P=0.12). The T/N differences between grade II and grade III have statistical significance (t=3.69, P<0.001). T/N value for tumor size <1cm and >1cm were 1.97±0.79 and 2.46±0.88 respectively; the difference between two have statistical significance (t=3.27, P=0.001).
 Conclusion: The semi-quantitative index of T/N correlates with clinico-pathological characteristics of tumor like: size, grade, and invasiveness of breast cancer, and at certain level can be helpful to determine patient’s prognosis.
Highlights
Breast cancer has long been recognized as one of the common malignancy among women in developed and developing countries
Mammography (MMG) is the only widely recognized first line radiologic examination used as a breast cancer screening method because of its high sensitivity and because it leads to reduced mortality [2]
Ductal Carcinoma In Situ (DCIS) with noncalcification, dense breast DCIS and lesion attached with or close to chest wall are misdiagnosed by MMG . [4,5] The sensitivity of mammography can be limited in young women especially
Summary
Breast cancer has long been recognized as one of the common malignancy among women in developed and developing countries. Ultrasound (US) is another commonly used anatomic imaging procedures to detect breast cancer It can detect small node-negative breast cancers, which increases the possibility of cancer diagnosis, especially in women with mammographically dense breast tissue; ultrasound has a high falsepositive rate, and there have been concerns about its operator dependence . . [19] 99mTc sestamibi clearance in tumor tissue is slower than that of surrounding normal tissues, previous studies have demonstrated that BSGI image can help in improving tumor detection rate . Patients going through neo-adjuvant chemotherapy or radiotherapy, pregnancy, biopsy within 3 days before radiological examinations is excluded
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