Can Scintimammography Help Differentiate the Nature of Suspected Masses Identified in Breast Ultrasound among Young Patients?

Abstract

Background

Breast cancer is the second leading cause of cancer deaths among women. Given the limitations of mammography in detecting breast cancer among young patients with suspected masses identified through ultrasound, our study aims to assess the effectiveness of scintimammography in distinguishing the nature of these masses.

Methods

The study included 123 patients between the ages of 18 and 35, who were presented with breast masses categorized as Breast Imaging-Reporting and Data System III and IV based on ultrasound findings. A total of 134 breast masses were identified in the patients through ultrasound examination. Patients underwent radiopharmaceutical injection of 99mTc-MIBI (technetium-99m methoxyisobutylisonitrile) with a 15 to 20 mCi dose. The radiopharmaceutical uptake in the scans was assessed using a scoring system ranging from 0 to 3. Then, the scores were compared with biopsy results.

Results

There was a statistically significant relationship between the absorption score reported by scintimammography and the pathological findings (p = 0.001). The sensitivity and specificity of scintimammography in malignant masses considering cutoff point of 2 for absorption score were 96 and 92%, respectively.

Conclusion

Based on the obtained results, scintimammography could be considered a diagnostic and complementary method to ultrasound in evaluating benign and malignant breast masses in young patients with dense breasts.

Keywords

scintimammography - ultrasound - biopsy

Ethical Considerations

The Ethics Committee approved our cross-sectional study, and informed consent was obtained. All patient information was strictly confidential. No additional costs were imposed on patients.

Publikationsverlauf

Artikel online veröffentlicht:
09. März 2025

• References

• 1 Lima ZS, Ebadi MR, Amjad G, Younesi L. Application of imaging technologies in breast cancer detection: a review article. Open Access Maced J Med Sci 2019; 7 (05) 838-848
• 2 Diggles L. Role of 99m Tc sestamibi scintimammography for the evaluation of breast lesions. Radionuclide Imag Breast. 2021; 31: 371
• 3 Khalkhali I, Tolmos J, Diggles L. Role of 99mTc Sestamibi Scintimammography for the Evaluation of Breast. Radionuclide Imaging of the Breast 2021; 371-396
• 4 Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin 2016; 66 (01) 7-30
• 5 Finn RS, Martin M, Rugo HS. et al. Palbociclib and letrozole in advanced breast cancer. N Engl J Med 2016; 375 (20) 1925-1936
• 6 Smith RA, DeSantis CE. Breast cancer epidemiology. Breast Imaging 2018; 1: 3-13
• 7 Jafari SH, Saadatpour Z, Salmaninejad A. et al. Breast cancer diagnosis: Imaging techniques and biochemical markers. J Cell Physiol 2018; 233 (07) 5200-5213
• 8 Aličković E, Subasi A. Breast cancer diagnosis using GA feature selection and rotation forest. Neural Comput Appl 2017; 28 (04) 753-763
• 9 Becker AS, Marcon M, Ghafoor S, Wurnig MC, Frauenfelder T, Boss A. Deep learning in mammography: diagnostic accuracy of a multipurpose image analysis software in the detection of breast cancer. Invest Radiol 2017; 52 (07) 434-440
• 10 Saulsberry L, Pace LE, Keating NL. The impact of breast density notification laws on supplemental breast imaging and breast biopsy. J Gen Intern Med 2019; 34 (08) 1441-1451
• 11 Heydarheydari S, Rezaeijo SM, Cheki M, Khodamoradi E, Khoshgard K. Diagnostic efficacy of technetium-99m-sestamibi scintimammography in comparison with mammography to detect breast lesions: a systematic review. Archives Breast Cancer 2018; 5 (03) 98-105
• 12 Sprague BL, Arao RF, Miglioretti DL. et al; Breast Cancer Surveillance Consortium. National performance benchmarks for modern diagnostic digital mammography: update from the Breast Cancer Surveillance Consortium. Radiology 2017; 283 (01) 59-69
• 13 Welch HG, Prorok PC, O'Malley AJ, Kramer BS. Breast-cancer tumor size, overdiagnosis, and mammography screening effectiveness. N Engl J Med 2016; 375 (15) 1438-1447
• 14 Ribeiro MP, Souza SA, Lopes FP, Rosado-de-Castro PH, Fonseca LM, Gutfilen B. 99mTc-thymine scintigraphy may be a promising method in the diagnosis of breast cancer. Clinics (Sao Paulo) 2013; 68 (03) 283-289
• 15 Novikov SN, Chernaya AV, Krzhivitsky PI. et al. ^99mTc-MIBI scintimammography and digital mammography in the diagnosis of multicentric breast cancer. Hell J Nucl Med 2019; 22 (03) 172-178
• 16 Turkmen C. Nuclear medicine imaging in breast cancer. Breast Cancer 2019; •••: 223-237
• 17 Conners AL, Maxwell RW, Tortorelli CL. et al. Gamma camera breast imaging lexicon. AJR Am J Roentgenol 2012; 199 (06) W767-74
• 18 Sharoon R, Hussain F, Ibrahim T, Raza M, Seher S. Diagnosric accuracy of 99mTc methoxyisobutylisonitrile(MIBI) scintimammography in detection of breast cancer. Pak Armed Forces Med J 2021; 71: 442-446
• 19 Grosso M, Chiacchio S, Bianchi F. et al. Comparison between 99mTc-sestamibi scintimammography and X-ray mammography in the characterization of clusters of microcalcifications: a prospective long-term study. Anticancer Res 2009; 29 (10) 4251-4257
• 20 Sun SS, Hsieh JF, Tsai SC, Ho YJ, Lee JK, Kao CH. The role of Tc-99m methoxyisobutylisonitrile scintimammography as compared to mammography in evaluating palpable breast masses of Taiwanese women. Anticancer Res 2000; 20 (3B): 2133-2136
• 21 Khalkhali I, Villanueva-Meyer J, Edell SL. et al. Diagnostic accuracy of 99mTc-sestamibi breast imaging: multicenter trial results. J Nucl Med 2000; 41 (12) 1973-1979
• 22 Scopinaro F, Schillaci O, Ussof W. et al. A three center study on the diagnostic accuracy of 99mTc-MIBI scintimammography. Anticancer Res 1997; 17 (3B): 1631-1634
• 23 Chernaia A, Mishchenko A, Novikov SN. et al. Comparative diagnostic performance of contrast-enhanced dual-energy spectral mammography, digital mammography and (99m) Tc MIBI scintimammography in detecting multicentric breast cancer. ECR 2020
• 24 Sampalis FS, Denis R, Picard D. et al. International prospective evaluation of scintimammography with (99m)technetium sestamibi. Am J Surg 2003; 185 (06) 544-549
• 25 Tiling R, Stephan K, Sommer H, Shabani N, Linke R, Hahn K. Tissue-specific effects on uptake of 99mTc-sestamibi by breast lesions: a targeted analysis of false scintigraphic diagnoses. J Nucl Med 2004; 45 (11) 1822-1828
• 26 Mulero F, Roca V, Nicolás F. et al. Usefulness of quantification and visual analysis of the uptake of (99m)Tc-MIBI in the diagnosis of mammary lesions [in Spanish]. Rev Esp Med Nucl 2000; 19 (03) 192-198
• 27 Horne T, Pappo I, Cohenpour M, Mindlin L, Orda R. 99Tcm-MIBI scintimammography for the detection of breast malignancies: the contribution of the count ratio to specificity. Nucl Med Commun 1999; 20 (06) 511-516