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The Clinical impact of breast scintigraphy acquired with a breast specific γ-camera (BSGC) in the diagnosis of breast cancer: incremental value versus mammography

Spanu, Angela and Sanna, Daniela and Chessa, Francesca and Manca, Alessandra and Cottu, Pierina and Fancellu, Alessandro and Nuvoli, Susanna Maria Francesca and Madeddu, Giuseppe (2012) The Clinical impact of breast scintigraphy acquired with a breast specific γ-camera (BSGC) in the diagnosis of breast cancer: incremental value versus mammography. International Journal of Oncology, Vol. 41 (2), p. 483-489. eISSN 1791-2423. Article.

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DOI: 10.3892/ijo.2012.1495

Abstract

We investigated the clinical impact of breast scintigraphy acquired with a breast specific γ-camera (BSGC) in the diagnosis of breast cancer (BC) and assessed its incremental value over mammography (Mx). A consecutive series of 467 patients underwent BSGC scintigraphy for different indications: suspicious lesions on physical examination and/or on US/MRI negative at Mx (BI-RADS 1 or 3), characterization of lesions suspicious at Mx (BI-RADS 4), preoperative staging in lesions highly suggestive of malignancy at Mx (BI-RADS 5). Definitive histopathological findings were obtained in all cases after scintigraphy: 420/467 patients had BC, while 47/467 patients had benign lesions. The scintigraphic data were correlated to Mx BI-RADS category findings and to histology. The incremental value of scintigraphy over Mx was calculated. Scintigraphy was true-positive in 97.1% BC patients, detecting 96.2% of overall tumor foci, including 91.5% of carcinomas ≤10 mm, and it was true-negative in 85.1% of patients with benign lesions. Scintigraphy gave an additional value over Mx in 141/467 cases (30.2%). In particular, scintigraphy ascertained BC missed at Mx in 31 patients with BI-RADS 1 or 3, including 26 patients with heterogeneously/high dense breast (19/26 with tumors ≤10 mm) and detected additional clinically occult ipsilateral or controlateral tumor foci (all <10 mm) or the in situ component sited around invasive tumors in 77 BC patients with BI-RADS 4 or 5, changing surgical management in 18.2% of these cases; moreover, scintigraphy ruled out malignancy in 33 patients with BI-RADS 4. BSGC scintigraphy proved a highly sensitive diagnostic tool, even in small size carcinoma detection, while maintaining a high specificity. The procedure increased both the sensitivity of Mx, especially in dense breast and in multifocal/multicentric disease, and the specificity as well as it better defined local tumor extension, thus guiding the surgeon to a more appropriate surgical treatment.

Item Type:Article
ID Code:8883
Status:Published
Refereed:Yes
Uncontrolled Keywords:Breast scintigraphy, breast specific γ-camera (BSGC), breast cancer (BC), mammography
Subjects:Area 06 - Scienze mediche > MED/36 Diagnostica per immagini e radioterapia
Area 06 - Scienze mediche > MED/18 Chirurgia generale
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Scienze Umanistiche e Sociali
001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Medicina Clinica e Sperimentale
Publisher:Editorial Academy of the International Journal of Oncology
eISSN:1791-2423
Deposited On:15 Apr 2013 12:37

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