99mTc sestamibi scintimammography in the diagnosis of palpable breast masses

The aim of this prospective study was to evaluate the diagnostic performance of Tc-99m sestamibi scintimammography in a region with a low incidence of breast cancer (East, central and West Africa) and to verify the clinical usefulness of this technique in identifying benign breast diseases. Thirty-eight women (age range 22-38 years) with palpable breast masses (n = 38) and inconclusive mammograms were included. Prone scintimammography was performed 10 min and 60-90 min in all patients after injection using an isotime acquisition of 10 min. A positive scan for breast cancer was defined as tracer uptake on the 10 min image and retention of activity on the 60-90 min image. A negative scan was defined as uptake on the 10 min image and complete washout of activity on the 60-90 min image. All patients subsequently underwent excisional biopsy of the breast masses and histological confirmation of the pathology. The results of scintimammography and histopathology were in agreement in all patients, revealing 36 benign lesions and two malignant lesions. Histopathologically, the lesions were fibroadenomas (27), fibrocystic disease (five), abscesses (four) and invasive intraductal carcinoma (two). It is concluded that, in regions with high incidence of benign breast diseases in young women, Tc-99m sestamibi scintimammography can be used to rapidly characterize benign and malignant breast masses and thereby give priority to the management of those with a serious condition. ((C) 2003 Lippincott Williams Wilkins).