Sestamibi Scintimammography in the evaluation of breast pathology

Abstract

Purpose: Breast cancer continues to be the leading cause of mortality in women. Current detection strategies include a physical exam and a mammography, which have a sensitivity of 85% to 90% and a positive predictive value of only 15% to 30%. Technitium-99m Sestamibi is a nuclear medicine agent that is concentrated in human carcinoma cell lines, including breast carcinoma. We studied the role of Sestamibi Scintimammography (MIBI) in the evaluation of breast pathology by evaluating its utility in the differentiation of benign from malignant breast pathology and the prediction of axillary lymph node involvement. MethodsA prospective study of 106 women was performed, in which all patients underwent standard mammography, MIBI, and pathological evaluation after biopsy. ResultsTable 1Table 1Results of breast pathologyPathologySestamibiPositiveNegativePositive4310Negative2033outlines the results of the breast pathology. The sensitivity, specificity, and positive and negative predictive values were 81%, 62%, 68%, and 76%, respectively. In predicting axillary lymph node involvement, the results were 71%, 93%, 83%, and 87%, respectively. ConclusionsWe conclude that MIBI has a role in the detection and evaluation of breast pathology, especially in the patient with dense breasts, in which the sensitivity and positive predictive value of standard evaluation is significantly lower. Its role in evaluating axillary lymph node status is promising and deserves further study. Additionally, it should be employed in the evaluation of patients with occult breast cancer.