Dedicated breast camera: is it the best option for scintimammography?
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Breast Neoplasms↗
Biomedical subjects
Leonard R Coover
Publications and source records attributed to Leonard R Coover.
Scintimammography with dedicated breast camera detects and localizes occult carcinoma.
UNLABELLED: This study assessed the utility of scintimammography using a standard gamma-camera and a dedicated breast camera as an adjuvant to mammography and clinical examination. METHODS: The study population comprised 37 patients with dense breasts and a family or personal history of breast cancer. The subjects had no suggestive clinical or mammographic findings. After intravenous administration of (99m)Tc-sestamibi, the patients were imaged using a conventional gamma-camera and a dedicated breast camera that allowed breast compression during image acquisition. Images were interpreted independently by 2 reviewers. All patients with positive scintimammography findings underwent biopsy. RESULTS: Dedicated breast camera results were positive in 13.5% (5/37) of patients. Biopsy of these 5 patients yielded 3 carcinomas: an infiltrating lobular carcinoma, a ductal carcinoma in situ, and an infiltrating tubular carcinoma. These 3 carcinomas were undetectable by clinical breast examination or mammography, even on retrospective review. Only one of these, the tubular carcinoma, was readily detectable by the standard gamma-camera. CONCLUSION: Scintimammography using a dedicated breast camera may augment mammography and clinical breast examination for the subset of women who have dense breast tissue and are at high risk of breast cancer.
Adult↗
Breast tumor localization using sestamibi.
PURPOSE: The sensitivity of sestamibi scanning is 85% for breast lesions that measure >or=1 cm in diameter. This detection technique complements mammography and clinical examination and can benefit patients with very dense breast tissue. An innovation in nuclear imaging uses a lead marker for localization. MATERIALS AND METHODS: A 53-year-old woman underwent scintigraphy to clarify the indeterminate findings of a mammogram. Left breast biopsies 7 and 8 years earlier had yielded benign results. Mammography revealed a somewhat asymmetric stromal pattern, but the tissue appeared stable compared with results of previous studies. No focal abnormalities were identified. The original sestamibi breast scan revealed focally increased sestamibi uptake in the left breast. She was referred for another sestamibi scan because no radiographic or palpable abnormality correlated with the scintigraphic findings, and the lesion was believed to be nonlocalizable. Histologic examination revealed high-grade, poorly differentiated infiltrating ductal adenocarcinoma. RESULTS: After intravenous administration of Tc-99m sestamibi, the site of the lesion was identified using a lead marker, the persistence scope, and localization needles. This facilitated surgical removal. CONCLUSION: Using a lead marker allows placement of localization wires to guide surgical breast biopsy in patients whose lesions are visible by scintigraphy but not via mammography or palpation.
Breast Neoplasms↗