Technetium-99m sestamibi scintimammography complements mammography in the detection of breast cancer

Gayathri Krishnaiah, Arifa Sher-Ahmed, Martins Ugwu-Dike, Patricia Regan, John Singer, Adil Totoonchie, Ethan Spiegler, Armando Sardi

Research output: Contribution to journalArticle

Abstract

Mammography remains the technique of choice for the detection of early breast cancer. The sensitivity of mammography is 85%, but is decreased in patients with dense breasts. Sestamibi scintimammography (SCM) has been suggested as an adjunctive modality to improve the detection of breast cancer. We conducted a study to determine the impact of SCM in patient management. A prospective study was conducted in 95 patients presenting with palpable masses and/or abnormal mammography scheduled for biopsy. Injection of 20-30 mCi of technetium-99m (Tc-99m) sestamibi into a pedal vein was performed. Ten-minute images of the breast and axilla were obtained in multiple projections. The mammography and SCM were correlated with pathology and clinical findings. The median age was 44 years (range 28-86 years). The total number of lesions was 104, as eight patients had bilateral lesions and one patient had two lesions in the same breast. Fifty-nine patients presented with palpable lesions and 45 patients with nonpalpable lesions (42 with abnormal mammography only and 3 with nipple discharge). A comparison of sensitivity, specificity, positive and negative predictive values, and overall accuracy of SCM and mammography were performed. The sensitivity and specificity for SCM were 83% and 83%, respectively, and for mammography were 65%, and 72%, respectively. The sensitivity and specificity for combined SCM and mammography were 87% and 94%, respectively. The p-value for mammography versus combined SCM and mammography was 0.0003 and that for SCM versus SCM and mammography was 0.0098. There were 80 (77%) benign and 24 (23%) malignant lesions. Of the 24 malignancies, SCM missed six (25%), versus eight (33%) by mammography. In two patients (9%) SCM detected malignancy in the breast that was not visualized by mammography or found on clinical examination. Sestamibi SCM improves the sensitivity of mammography and it detects up to 9% of malignancies not detected by mammography or clinical examination. This testing could impact the management of 16,500 patients in the United States every year. More studies are needed to better define its role in breast cancer detection.

Original languageEnglish (US)
Pages (from-to)288-294
Number of pages7
JournalBreast Journal
Volume9
Issue number4
DOIs
StatePublished - Jul 2003
Externally publishedYes

Fingerprint

Technetium Tc 99m Sestamibi
Mammography
Breast Neoplasms
Breast
Sensitivity and Specificity
Neoplasms
Axilla
Clinical Pathology

Keywords

  • Mammography
  • Scintimammography
  • Sestamibi
  • Technetium-99m

ASJC Scopus subject areas

  • Internal Medicine
  • Oncology

Cite this

Krishnaiah, G., Sher-Ahmed, A., Ugwu-Dike, M., Regan, P., Singer, J., Totoonchie, A., ... Sardi, A. (2003). Technetium-99m sestamibi scintimammography complements mammography in the detection of breast cancer. Breast Journal, 9(4), 288-294. https://doi.org/10.1046/j.1524-4741.2003.09407.x

Technetium-99m sestamibi scintimammography complements mammography in the detection of breast cancer. / Krishnaiah, Gayathri; Sher-Ahmed, Arifa; Ugwu-Dike, Martins; Regan, Patricia; Singer, John; Totoonchie, Adil; Spiegler, Ethan; Sardi, Armando.

In: Breast Journal, Vol. 9, No. 4, 07.2003, p. 288-294.

Research output: Contribution to journalArticle

Krishnaiah, G, Sher-Ahmed, A, Ugwu-Dike, M, Regan, P, Singer, J, Totoonchie, A, Spiegler, E & Sardi, A 2003, 'Technetium-99m sestamibi scintimammography complements mammography in the detection of breast cancer', Breast Journal, vol. 9, no. 4, pp. 288-294. https://doi.org/10.1046/j.1524-4741.2003.09407.x
Krishnaiah, Gayathri ; Sher-Ahmed, Arifa ; Ugwu-Dike, Martins ; Regan, Patricia ; Singer, John ; Totoonchie, Adil ; Spiegler, Ethan ; Sardi, Armando. / Technetium-99m sestamibi scintimammography complements mammography in the detection of breast cancer. In: Breast Journal. 2003 ; Vol. 9, No. 4. pp. 288-294.
@article{c8dbd6c2939a4a6f861e34fbf5eeefc8,
title = "Technetium-99m sestamibi scintimammography complements mammography in the detection of breast cancer",
abstract = "Mammography remains the technique of choice for the detection of early breast cancer. The sensitivity of mammography is 85{\%}, but is decreased in patients with dense breasts. Sestamibi scintimammography (SCM) has been suggested as an adjunctive modality to improve the detection of breast cancer. We conducted a study to determine the impact of SCM in patient management. A prospective study was conducted in 95 patients presenting with palpable masses and/or abnormal mammography scheduled for biopsy. Injection of 20-30 mCi of technetium-99m (Tc-99m) sestamibi into a pedal vein was performed. Ten-minute images of the breast and axilla were obtained in multiple projections. The mammography and SCM were correlated with pathology and clinical findings. The median age was 44 years (range 28-86 years). The total number of lesions was 104, as eight patients had bilateral lesions and one patient had two lesions in the same breast. Fifty-nine patients presented with palpable lesions and 45 patients with nonpalpable lesions (42 with abnormal mammography only and 3 with nipple discharge). A comparison of sensitivity, specificity, positive and negative predictive values, and overall accuracy of SCM and mammography were performed. The sensitivity and specificity for SCM were 83{\%} and 83{\%}, respectively, and for mammography were 65{\%}, and 72{\%}, respectively. The sensitivity and specificity for combined SCM and mammography were 87{\%} and 94{\%}, respectively. The p-value for mammography versus combined SCM and mammography was 0.0003 and that for SCM versus SCM and mammography was 0.0098. There were 80 (77{\%}) benign and 24 (23{\%}) malignant lesions. Of the 24 malignancies, SCM missed six (25{\%}), versus eight (33{\%}) by mammography. In two patients (9{\%}) SCM detected malignancy in the breast that was not visualized by mammography or found on clinical examination. Sestamibi SCM improves the sensitivity of mammography and it detects up to 9{\%} of malignancies not detected by mammography or clinical examination. This testing could impact the management of 16,500 patients in the United States every year. More studies are needed to better define its role in breast cancer detection.",
keywords = "Mammography, Scintimammography, Sestamibi, Technetium-99m",
author = "Gayathri Krishnaiah and Arifa Sher-Ahmed and Martins Ugwu-Dike and Patricia Regan and John Singer and Adil Totoonchie and Ethan Spiegler and Armando Sardi",
year = "2003",
month = "7",
doi = "10.1046/j.1524-4741.2003.09407.x",
language = "English (US)",
volume = "9",
pages = "288--294",
journal = "Breast Journal",
issn = "1075-122X",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Technetium-99m sestamibi scintimammography complements mammography in the detection of breast cancer

AU - Krishnaiah, Gayathri

AU - Sher-Ahmed, Arifa

AU - Ugwu-Dike, Martins

AU - Regan, Patricia

AU - Singer, John

AU - Totoonchie, Adil

AU - Spiegler, Ethan

AU - Sardi, Armando

PY - 2003/7

Y1 - 2003/7

N2 - Mammography remains the technique of choice for the detection of early breast cancer. The sensitivity of mammography is 85%, but is decreased in patients with dense breasts. Sestamibi scintimammography (SCM) has been suggested as an adjunctive modality to improve the detection of breast cancer. We conducted a study to determine the impact of SCM in patient management. A prospective study was conducted in 95 patients presenting with palpable masses and/or abnormal mammography scheduled for biopsy. Injection of 20-30 mCi of technetium-99m (Tc-99m) sestamibi into a pedal vein was performed. Ten-minute images of the breast and axilla were obtained in multiple projections. The mammography and SCM were correlated with pathology and clinical findings. The median age was 44 years (range 28-86 years). The total number of lesions was 104, as eight patients had bilateral lesions and one patient had two lesions in the same breast. Fifty-nine patients presented with palpable lesions and 45 patients with nonpalpable lesions (42 with abnormal mammography only and 3 with nipple discharge). A comparison of sensitivity, specificity, positive and negative predictive values, and overall accuracy of SCM and mammography were performed. The sensitivity and specificity for SCM were 83% and 83%, respectively, and for mammography were 65%, and 72%, respectively. The sensitivity and specificity for combined SCM and mammography were 87% and 94%, respectively. The p-value for mammography versus combined SCM and mammography was 0.0003 and that for SCM versus SCM and mammography was 0.0098. There were 80 (77%) benign and 24 (23%) malignant lesions. Of the 24 malignancies, SCM missed six (25%), versus eight (33%) by mammography. In two patients (9%) SCM detected malignancy in the breast that was not visualized by mammography or found on clinical examination. Sestamibi SCM improves the sensitivity of mammography and it detects up to 9% of malignancies not detected by mammography or clinical examination. This testing could impact the management of 16,500 patients in the United States every year. More studies are needed to better define its role in breast cancer detection.

AB - Mammography remains the technique of choice for the detection of early breast cancer. The sensitivity of mammography is 85%, but is decreased in patients with dense breasts. Sestamibi scintimammography (SCM) has been suggested as an adjunctive modality to improve the detection of breast cancer. We conducted a study to determine the impact of SCM in patient management. A prospective study was conducted in 95 patients presenting with palpable masses and/or abnormal mammography scheduled for biopsy. Injection of 20-30 mCi of technetium-99m (Tc-99m) sestamibi into a pedal vein was performed. Ten-minute images of the breast and axilla were obtained in multiple projections. The mammography and SCM were correlated with pathology and clinical findings. The median age was 44 years (range 28-86 years). The total number of lesions was 104, as eight patients had bilateral lesions and one patient had two lesions in the same breast. Fifty-nine patients presented with palpable lesions and 45 patients with nonpalpable lesions (42 with abnormal mammography only and 3 with nipple discharge). A comparison of sensitivity, specificity, positive and negative predictive values, and overall accuracy of SCM and mammography were performed. The sensitivity and specificity for SCM were 83% and 83%, respectively, and for mammography were 65%, and 72%, respectively. The sensitivity and specificity for combined SCM and mammography were 87% and 94%, respectively. The p-value for mammography versus combined SCM and mammography was 0.0003 and that for SCM versus SCM and mammography was 0.0098. There were 80 (77%) benign and 24 (23%) malignant lesions. Of the 24 malignancies, SCM missed six (25%), versus eight (33%) by mammography. In two patients (9%) SCM detected malignancy in the breast that was not visualized by mammography or found on clinical examination. Sestamibi SCM improves the sensitivity of mammography and it detects up to 9% of malignancies not detected by mammography or clinical examination. This testing could impact the management of 16,500 patients in the United States every year. More studies are needed to better define its role in breast cancer detection.

KW - Mammography

KW - Scintimammography

KW - Sestamibi

KW - Technetium-99m

UR - http://www.scopus.com/inward/record.url?scp=0043167889&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0043167889&partnerID=8YFLogxK

U2 - 10.1046/j.1524-4741.2003.09407.x

DO - 10.1046/j.1524-4741.2003.09407.x

M3 - Article

C2 - 12846862

AN - SCOPUS:0043167889

VL - 9

SP - 288

EP - 294

JO - Breast Journal

JF - Breast Journal

SN - 1075-122X

IS - 4

ER -