technetium-tc-99m-tetrofosmin and Breast-Diseases

Topics: Adult; Artifacts; Axilla; Biopsy; Breast Diseases; Breast Neoplasms; Carcinoma; Carcinoma, Ductal, Breast; Chemotherapy, Adjuvant; Drug Resistance, Multiple; Drug Resistance, Neoplasm; False Positive Reactions; Female; Forecasting; Humans; Lymphatic Metastasis; Magnetic Resonance Imaging; Mammography; Middle Aged; Multicenter Studies as Topic; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Organophosphorus Compounds; Organotechnetium Compounds; Patient Selection; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Thallium Radioisotopes; Ultrasonography

201Tl and 99Tcm-MIBI have been used to evaluate palpable breast masses. The aim of this study was to evaluate the potential of 99Tcm-tetrofosmin as a new tumour localizing agent in patients with palpable breast masses. Nineteen palpable breast masses were evaluated in 18 patients. Each patient received 740 MBq 99Tcm-tetrofosmin intravenously. Ten minutes after the injection, planar breast images in the anterior, right lateral and left lateral views were obtained with the patient in the supine position. Mammography and ultrasonography were performed in all patients. Biopsy or mastectomy with axillary dissection was performed in all patients. Thirteen of 14 primary breast tumours were detected (9 invasive ductal carcinomas, 3 invasive lobular carcinomas, 1 papillary carcinoma). One patient with mucinous carcinoma did not demonstrate 99Tcm-tetrofosmin accumulation. Four of five patients with histopathologically proven benign lesions did not demonstrate 99Tcm-tetrofosmin accumulation (2 fibrocystic diseases, 2 fibroadenomas). 99Tcm-tetrofosmin accumulation was seen in a patient with chronic mastitis. The sensitivity and specificity of 99Tcm-tetrofosmin for malignant breast lesions was 92 and 80% respectively. Four of seven (57%) axillary lymph node metastases showed 99Tcm-tetrofosmin uptake. In conclusion, 99Tcm-tetrofosmin shows real promise for use in evaluating patients with palpable breast masses.

Topics: Adult; Aged; Breast; Breast Diseases; Breast Neoplasms; Breast Neoplasms, Male; Female; Fibroadenoma; Fibrocystic Breast Disease; Humans; Male; Mammography; Mastitis; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Physical Examination; Sensitivity and Specificity; Tomography, Emission-Computed

To compare technetium-99m tetrofosmin scintimammography with contrast material-enhanced magnetic resonance (MR) imaging in the characterization of palpable breast masses.. Forty-seven patients (mean age, 51 years) with a palpable breast mass were prospectively examined with scintimammography, MR imaging, and conventional mammography 2 weeks before fine-needle aspiration biopsy.. In three patients, MR imaging was aborted. Of the remaining 44 patients, 21 had biopsy-proved cancer and 23 had benign disease. The sensitivity of mammography was 81%; specificity, 82%; positive predictive value (PPV), 85%; and negative predictive value (NPV), 78%. The sensitivity of scintimammography was 95%; specificity, 91%; PPV, 91%; and NPV, 95%. The sensitivity of MR imaging was 90%; specificity, 91%; PPV, 90%; and NPV, 91%. In 11 patients with previous breast cancer, scintimammographic findings were positive in all four with tumor recurrence and negative in all seven with benign disease. Masses were correctly characterized with MR imaging in eight of these 11 patients.. Although both techniques accurately differentiate benign from malignant palpable breast masses, scintimammography is more accurate in the posttreatment breast. Because of lower cost, wider availability, and high patient acceptance, scintimammography may provide a valuable alternative to MR imaging for noninvasive characterization of palpable breast disease.

Topics: Adult; Aged; Biopsy, Needle; Breast; Breast Diseases; Breast Neoplasms; Contrast Media; Female; Gadolinium; Gadolinium DTPA; Humans; Magnetic Resonance Imaging; Mammography; Middle Aged; Organometallic Compounds; Organophosphorus Compounds; Organotechnetium Compounds; Palpation; Pentetic Acid; Predictive Value of Tests; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Subtraction Technique

Despite low specificity routine mammography is the method of choice to screen women for breast cancer. In addition high frequency ultrasonography (US) or magnetic resonance imaging (MRI) can improve breast cancer diagnosis. However there is a lack of conventional imaging to improve the high rate of false positive results that make biopsy or surgery necessary.. The purpose of our study was to evaluate prospectively the sensitivity, specificity, PPV and NPV of scintimammography with a new cationic complex Tc-99m-tetrofosmin.. Fourtyeight patients in whom mammography and/or high resolution ultrasonography (10 MHz) revealed suspicious breast lesions were studied with Tc-99m-tetrofosmin scintimammography. In thirtyfour of them biopsy and/or surgery was performed for histological evaluation. After intravenous injection of 555 MBq Tc-99m-tetrofosmin dynamic images over three minutes (1 frame/10 sec.) planar images in anterior and lateral projections (5 min. p.i.) and SPECT imaging including 3-D-reconstruction (20 min. p.i.) were performed. Scintimammography was evaluated as negative, equivocal (+), probably (+2) or definitely (+3) positive. Scintimammography with Tc-99m-tetrofosmin was negative in 18 patients (17 t.p., 1 f.n.) and positive in 16 patients (10 t.p., 6 f.p.). The false negative scintimammography was observed in a patient with infiltrating ductal carcinoma pT1, the false positive results in a patient with fibrocystic disease; all of the five fibroadenomas were also "false" positive. Sensitivity of Tc-99m-tetrofosmin scintimammography in this prospective study was 91%, specificity 74%, PPV 63% and NPV 94%. Scintimammographic results in patients with suspicious breast lesion show, that Tc-99m-tetrofosmin accumulates in breast cancer as well as in fibroadenoma. However the high NPV of 94% excludes breast cancer in suspicious mammographic lesions in a very high degree and therefore reduces the need of biopsy and/or surgery in most of these patients. Our first results show that scintimammography with Tc-99m-tetrofosmin might play a role as further diagnostic step before surgery for women in whom mammography and/or ultrasonography show suspicious lesions.

Topics: Adult; Aged; Breast; Breast Diseases; Breast Neoplasms; Carcinoma, Ductal, Breast; Female; Fibrocystic Breast Disease; Humans; Mammography; Middle Aged; Necrosis; Organophosphorus Compounds; Organotechnetium Compounds; Prospective Studies; Tomography, Emission-Computed, Single-Photon; Ultrasonography, Mammary