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Comparative Value of ^99mTc-Sestamibi Scintimammography and Sonography in the Diagnostic Workup of Breast Masses

¹ Radiology Imaging Associates and The Sally Jobe Breast Center, 8200 E. Belleview Ave., Englewood, CO 80111.
² Present Address: Wellspring Breast Center, Physicians Building South, Community General Hospital, 4000 Broad Rd., Syracuse, NY 13215.

OBJECTIVE. This study was conducted to assess the relative roles of ^99mTc-sestamibi scintimammography and sonography in the evaluation of breast lesions that are indeterminate or suspicious on mammography or clinical examination.

SUBJECTS AND METHODS. Twenty-five patients with 33 biopsy-proven breast lesions underwent both scintimammography and sonography. Lesions were categorized as benign or requiring biopsy on the basis of the absence or presence of a focus of increased activity on scintimammography and the shape, orientation, and echogenicity of the lesion on sonography.

RESULTS. Sensitivity and specificity in detecting breast cancer were 92% and 95%, respectively, for scintimammography and 100% and 48%, respectively, for sonography. The higher specificity of scintimammography was statistically significant (p < 0.01).

CONCLUSION. Although the overall accuracy of ^99mTc-sestamibi scintimammography in the diagnosis of breast cancer was high, it has several disadvantages in comparison with sonography. Scintimammography has a slightly higher false-negative rate for breast cancer, is unable to reveal cysts, is more expensive, takes longer to perform, and involves ionizing radiation. For these reasons, scintimammography with ^99mTc- sestamibi is unlikely to either replace sonography or be frequently used in addition to sonography.

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