63. Scintimammography in recurrent breast cancer: A primary or secondary role?

Kolasinska, A.; Ćwikła, Jarosław B.; Buscombe, J. R.; Parbhoo, S. P.; Davidson, T.; Holloway, B.; MacDermott, Kristin; Hilson, A. J.W.

doi:10.1097/00006231-200004000-00075

Cited by 4 publications

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“…negative findings in 3 patients. These results are similar to those reported by Kolasinska et al [17]. In our study, false-negative scans were obtained from lesions that were ,2 cm in size, in line with the finding that SMM has low sensitivity for detecting small lesions below 1¡1.5 cm in size [18].…”

Section: Discussionsupporting

confidence: 93%

Scintimammography in conjunction with ultrasonography for local breast cancer recurrence in post-mastectomy breast

Usmani¹,

Khan²,

Ahmed³

et al. 2010

BJR

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The aim of this study was to compare the usefulness of (99)Tc(m)-methoxy-isobutyl-isonitrile (MIBI) scintimammography and ultrasonography, alone and in combination, for the detection of chest wall recurrence in the post-mastectomy breast. A total of 41 consecutive post-mastectomy patients (mean age 46.6 years; median age 45 years) with clinical suspicion of breast cancer recurrence were evaluated. For scintimammography all patients received a 740-900 MBq iv injection of (99)Tc(m)-MIBI; planar images were taken 5-10 min post-injection followed by supine single photon emission CT. Breast ultrasonography was performed in each patient using a 7.5 MHz transducer. Both MIBI uptake and ultrasound findings were documented using standard protocols. All patients had fine needle aspiration cytology biopsy (FNAC), core biopsy or excision biopsy for final tissue diagnosis. Of the 41 patients, 24 had true positive signs of local breast cancer recurrence upon ultrasonography, 10 were diagnosed as true negatives, a sensitivity of 86%, specificity 77%, positive predictive value (PPV) 89%, negative predictive value (NPV) 71% and accuracy 83% (p = 0.001). By comparison, scintimammography findings were found to be true positive in 25 patients and true negative in 12 patients - sensitivity 89%, specificity 92%, PPV 96%, NPV 80% and accuracy 90% (p = 0.001). Using a combination of these two modalities, the combined sensitivity was 100%, specificity 77%, PPV 90%, NPV 100% and accuracy 93%. The high NPV of the two studies in combination implies a potential use of this approach to exclude recurrent disease in patients with a low initial index of suspicion and/or when histology is indeterminate.

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Section: Discussionsupporting

confidence: 93%

Scintimammography in conjunction with ultrasonography for local breast cancer recurrence in post-mastectomy breast

Usmani¹,

Khan²,

Ahmed³

et al. 2010

BJR

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“…This sensitivity is comparable and slightly better than international standards which describe a sensitivity on mammography of 55% – 68%. 5 , 44 , 45 We anticipate that the use of contrast enhanced mammogram at our institution will assist in improving diagnostic imaging accuracy. 46 Features which correlated with benign breast changes included absence of skin thickening (> 3 mm), indistinct and coarse calcifications, absence of lymphadenopathy.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of breast conserving therapy: Recurrence, imaging findings and histological correlation

2023

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Background: Breast conserving therapy (BCT) is the mainstay therapy in patients with early breast cancer and selected patients with locally advanced breast cancer. No formal audit has been performed on BCT at our institution.Objectives: To determine the incidence and risk factors for ipsilateral breast tumour recurrence (IBTR). Study the imaging features of IBTR. Determine adherence to the proposed annual mammographic surveillance schedule.Method: Clinical, radiological and histopathological records of patients who underwent BCT from 01 January 2011 to 31 December 2015 were reviewed. Patients were followed up for at least 5 years.Results: Ninety-two patients were included in the study with a mean age of 54.3 years. Eighty of the 92 (87.0%) patients were imaged within 1-year post-BCT. Ipsilateral breast tumour recurrence was 6/92 (6.5%) with mean time to IBTR of 34.4 months. One of the 92 (1.0%) patients had a contralateral metachronous recurrence with no IBTR and 11/92 (12.0%) had distant metastases only. Pathological tumour size and extent (pT2) (68.5%) and pathological lymph node (pN0) (65.2%) were the most common locoregional staging. Infiltrating ductal carcinoma was the most common histological type (88%). Age 35 years was associated with breast cancer recurrence (p 0.01). Imaging findings of recurrence were microcalcification (odds ratio [OR]: 4), asymmetric density (OR: 4) and skin thickening (OR: 2.5).Conclusion: The occurrence of IBTR following BCT in our unit is acceptable and comparable to local and international units. The accuracy of assessing the post-BCT breast for IBTR is in keeping with international standards.Contribution: Improved radiological imaging interpretation of the post-BCT breast.

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“…cell proliferation and desmoplastic activity factors also seem to be involved (18). the presence of architectural distortion and diffuse or localized increase in breast density do not change the 99m tc-sestamibi uptake in the lesion (19)(20)(21)(22)(23)(24).…”

Section: Introductionmentioning

confidence: 92%

Accuracy of 99mTc-sestamibi scintimammography for breast cancer diagnosis

Moriguchi¹,

Luca²,

Griva³

et al. 2010

Experimental and Therapeutic Medicine

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Abstract. Scintimammography using 99m tc-sestamibi is a noninvasive and painless diagnostic imaging method that is used to detect breast cancer when mammography is inconclusive. Because of the advantages of labeling with 99m Tc-sestamibi and its high efficiency in detecting carcinomas, it is the most widespread agent for this purpose. its accumulation in the tumor has multifactorial causes and does not depend on the presence of architectural distortion or local or diffuse density variation in the breast. the objective of this study was to evaluate the accuracy of scintimammography for detecting breast cancer. One hundred and fifty-seven patients presenting 158 palpable and non-palpable breast nodules were evaluated. three patients were male and 154 were female, aged between 14 and 81 years. all patients underwent scintimammography, and the nodule was subjected to cytological or histological study, i.e., the gold standard for diagnosing cancer. One hundred and eleven malignant and 47 benign nodules were detected, with predominance of ductal carcinomas (n=94) and fibroadenoma/fibrocystic condition (n=11/n=11), respectively. The mean size was 3.11 cm (7-10 cm) among the malignant nodules and 2.07 cm among the benign nodules (0.5-10 cm). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 89, 89, 95, 78 and 89%, respectively. analysis on the histological types showed that the technique was more effective on tumors that were more aggressive, such as ductal carcinoma. in this study, 99m tc-sestamibi scintimammography was shown to be an important tool for diagnosing breast cancer when mammography was inconclusive.Introduction mammography is the safest method for breast cancer screening (1-3). It presents good sensitivity for detecting palpable and non-palpable lesions and low specificity for distinguishing between benign and malignant processes (4). hence, a biopsy is often required for diagnostic confirmation (5). It also presents limitations in relation to detection of lesions in dense breasts (6-8). mann et al demonstrated that false negative mammograms cause delays in undertaking biopsies among patients with cancer (9). the high rates of unnecessary biopsies in cases of benign lesions (10) have encouraged research on non-invasive techniques with greater precision. ultrasound, magnetic resonance imaging, positron emission tomography and scintigraphy are important aids for detecting cancer when mammography is indeterminate (11). high-risk patients (e.g., family antecedents, atypical proliferative lesions and previous cancer subjected to tumorectomy or radiotherapy) have benefited from combined use of these methods (11). Scintigraphy is a noninvasive imaging examination that uses small doses of radiation (12). it is painless, its cost and availability are reasonable and it enables functional or metabolic evaluation of various organs or structures. its advantage is unequivocal, especially when analysis using other methods is limited, and it stands out as a diagnostic eva...

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63. Scintimammography in recurrent breast cancer: A primary or secondary role?

Cited by 4 publications

References 0 publications

Scintimammography in conjunction with ultrasonography for local breast cancer recurrence in post-mastectomy breast

Scintimammography in conjunction with ultrasonography for local breast cancer recurrence in post-mastectomy breast

Outcomes of breast conserving therapy: Recurrence, imaging findings and histological correlation

Accuracy of 99mTc-sestamibi scintimammography for breast cancer diagnosis

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