Scintimammography screening for recurrent breast cancer in women

Abstract

Scintimammography (SM) is a nuclear medicine technique in which a tumour seeking radionuclide is used to localize or trace an active or residual tumour in breast tissue. It involves the injection of a radiopharmaceutical into circulation and obtaining a scan of the breast tissue 10-15min later. This procedure has been shown to be an accurate diagnostic tool in patients with symptomatic breast lesion with a non-diagnostic mammogram and for whom characterizing the lesion becomes important. This retrospective study was done using the case records of all 72 patients who had presented for scintimammography on follow -up for breast conservation surgery from January to August 2005. The result of scintimammography done using 99m Tc tetrofosmin method was compared with mammograms and cytology reports when available. A total number of 52 patients, mean age 49.4 ± 8.71 years (range35-67) were analyzed. The commonest presentation was induration at site of surgery. In 43 patients without recurrent disease, scintimammography correctly characterized 42 while 8 out of the 10 patients with recurrent disease confirmed by histology reports were correctly identified The sensitivity of this study was 88.8%, while specificity was 95.4%. The positive predictive value was 80%, while the negative predictive value was 95.3%. Given the non-invasiveness of scintimammography and the high diagnostic index, it is a very useful tool in breast cancer diagnosis and follow-up. Furthermore, the radiation dose to the patient is lower than a chest radiograph and as such the fear of radiation comparatively is milder.