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01-12-2011

Single-Photon-Emission Computed Tomography (SPECT) with Technetium-99m Sestamibi in the Diagnosis of Small Breast Cancer and Axillary Lymph Node Involvement

Authors: Alessandro de Cesare, De Vincentis Giuseppe, Gervasi Stefano, Crescentini Giacomo, Fiori Enrico, Bonomi Marco, Alessandro Crocetti, Antonio V. Sterpetti

Published in: World Journal of Surgery | Issue 12/2011

Abstract

Background

In a prospective study we evaluated the accuracy, sensitivity, and specificity of single-photon-emission computed tomography (SPECT) technetium-99m (99Tcm) sestamibi scintimammography to differentiate between benign and malignant small solid lesions of the breast, and to diagnose axillary node involvement in patients with small breast tumors.

Methods

We prospectively evaluated 172 women with a solid lesion of the breast less than 3 cm in diameter and no evidence of axillary lymph node involvement on physical examination, ultrasound, and mammography. Thereafter, all patients underwent excision of the lesion, and, if pathology was positive for cancer, quadrantectomy and axillary lymph node dissection independently by the results of scintimammography.

Results

There were 92 patients with a benign lesion and 80 patients with cancer. SPECT scintimammography correctly identified all 80 patients with cancer; there were six false-positive cases and no false-negative cases for a test efficacy of 96.5%, sensitivity of 100%, and specificity of 93.5%. Forty-five of the 80 patients with cancer had axillary lymph node involvement and scintimammography correctly identified 39 of the 45 patients. There was one false-positive case and six false-negative cases for a test efficacy of 90%, sensitivity of 86.4%, and specificity of 97.5%.

Conclusion

SPECT scintimammography should be considered selectively in the preoperative evaluation of patients with small solid lesions of the breast. It allows correct identification of patients with cancer and identification of a significant number of patients with axillary lymph node involvement.

Houssami N, Abraham LA, Miglioretti DL, Sickles EA, Kerlikowske K, Buist DS, Geller BM, Muss HB, Irwig L (2011) Accuracy and outcomes of screening mammography in women with a personal history of early-stage breast cancer. J Am Med Assoc 305:790–799CrossRef

Feig SA (2007) Auditing and benchmarks in screening and diagnostic mammography. Radiol Clin North Am 45:791–800PubMedCrossRef

Aarts MJ, Voogd AC, Duijm LE, Coebergh JW, Louwman WJ (2011) Socioeconomic inequalities in attending the mass screening for breast cancer in the south of Netherlands—association with stage at diagnosis and survival. Breast Cancer Res Treat 128(2):517–525PubMedCrossRef

Rhodes DJ, O’Connor MK, Phillips SW, Smith RL, Collins DA (2005) Molecular breast imaging: a new technique using technetium Tc 99m scintimammography to detect small tumours of the breast. Mayo Clin Proc 80:24–30PubMedCrossRef

Mechmandarov S, Sandbank J, Cohen M, Lelcuk S, Lubin E (1998) Technetium-99m-MIBI scintimammography in palpable and not palpable breast lesions. J Nucl Med 39:86–91

Gilbert FJ, Astley SM, Gillan MG, Agbaje OF, Wallis MG, James J, Boggis CR, Duffy SW, CADET II group (2008) Single reading with computed-aided detection for screening mammography. N Engl J Med 359:1675–1684PubMedCrossRef

Kalager M, Zelen M, Langmark F, Adami HO (2010) Effect of screening mammography on breast-cancer mortality in Norway. N Engl J Med 363:1203–1210PubMedCrossRef

Medeiros LR, Duarte CS, Rosa DD, Edelweiss MI, Edelweiss M, Silva FR, Winnikov EP, Simoes Pires PD, Rosa MI (2011) Accuracy of magnetic resonance in suspicious breast lesions: a systematic quantitative review and meta analysis. Breast Cancer Res Treat 126(2):273–285PubMedCrossRef

Warner E, Messersmith H, Causer P, Eisen A, Shumak R, Plewes D (2008) Systematic review: using magnetic resonance imaging to screen women at high risk for cancer. Ann Int Med 148:671–679PubMed

10.

Landercasper J, Linebarger JH (2011) Contemporary breast imaging and concordance assessment. A surgical perspective. Surg Clin North Am 91:249–266CrossRef

11.

Satake H, Nishio A, Ikeda M, Ishigaki S, Shimamoto K, Hirano M, Naganawa S (2011) Predictive value for malignancy of suspicious breast masses of BI-RADS categories 4 and 5 using ultrasound elastography and MR diffusion-weighted imaging. AJR Am J Roentgenol 196:202–209PubMedCrossRef

12.

Spanoudaki VC, Lau FW, Vandenbrouke A, Levin CS (2010) Physical effects of mechanical design parameters on photon sensitivity and spatial resolution sensitivity of a breast-dedicated system PET system. Med Phys 37:5038–5049CrossRef

13.

Chowdary PD, Jiang Z, Chaney EJ, Benalcazar WA, Marks DL, Gruebele M, Boppart SA (2010) Molecular histopathology by spectrally reconstructed nonlinear interferometric vibrational imaging. Cancer Res 70:9562–9569PubMedCrossRef

14.

Coover LR, Caravaglia G, Kuhn P (2004) Scintimammography with dedicated breast camera detects and localizes occult carcinoma. J Nucl Med 45:553–555PubMed

15.

Brem RF, Schoonjans JM, Kieper DA, Majewsky S, Goodman S, Civelek C (2002) High-resolution scintimammography: a pilot study. J Nucl Med 43:909–915PubMed

16.

Mueller B, O’Connor MK, Blevis I (2003) Evaluation of a small cadmium zinc telluride detector for scintimammography. J Nucl Med 44:602–609PubMed

17.

Mankoff DA, Dunwald LK, Gralov JR et al (2002) Tc-99m-sestamibi uptake and washout in locally advanced breast cancer are correlated with tumour blood flow. Nucl Med Biol 29:719–727PubMedCrossRef

18.

Kuenen-Booumesteer V, Menke-Phymers M, de Kanter AY, Obdeijn IMA, Urich D, Van de Kwast TH (2003) Ultrasound-guided needle aspiration cytology of axillary nodes in breast cancer patients: a preoperative staging procedure. Eur J Cancer 39:170–174CrossRef

19.

Lumachi F, Tregnaghi A, Ferretti G, Popolato M, Marzola MC, Zucchetta P, Cecchin D, Bui F (2006) Accuracy of ultrasonography and 99m Tc-sestamibi scintimammography for assessing axillary lymph node status in breast cancer patients: a prospective study. Eur J Surg Oncol 32:933–936PubMedCrossRef

20.

Dunwald LK, Gralow JR, Ellis GK, Livingston RB, Linden HM, Lawton TJ, Barlow WE, Schubert EK, Mankoff DA (2005) Residual tumour uptake of 99m-Tc-sestamibi after neoadjuvant chemotherapy for locally advanced breast carcinoma predicts survival. Cancer 103:680–688CrossRef

Title: Single-Photon-Emission Computed Tomography (SPECT) with Technetium-99m Sestamibi in the Diagnosis of Small Breast Cancer and Axillary Lymph Node Involvement
Authors: Alessandro de Cesare
De Vincentis Giuseppe
Gervasi Stefano
Crescentini Giacomo
Fiori Enrico
Bonomi Marco
Alessandro Crocetti
Antonio V. Sterpetti
Publication date: 01-12-2011
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 12/2011
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-011-1267-4

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Single-Photon-Emission Computed Tomography (SPECT) with Technetium-99m Sestamibi in the Diagnosis of Small Breast Cancer and Axillary Lymph Node Involvement

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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