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

  • Authors:
    • Angela Spanu
    • Daniela Sanna
    • Francesca Chessa
    • Alessandra Manca
    • Pierina Cottu
    • Alessandro Fancellu
    • Susanna Nuvoli
    • Giuseppe Madeddu
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  • Published online on: May 24, 2012     https://doi.org/10.3892/ijo.2012.1495
  • Pages: 483-489
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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.
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August 2012
Volume 41 Issue 2

Print ISSN: 1019-6439
Online ISSN:1791-2423

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Spandidos Publications style
Spanu A, Sanna D, Chessa F, Manca A, Cottu P, Fancellu A, Nuvoli S and Madeddu G: The clinical impact of breast scintigraphy acquired with a breast specific γ-camera (BSGC) in the diagnosis of breast cancer: Incremental value versus mammography. Int J Oncol 41: 483-489, 2012
APA
Spanu, A., Sanna, D., Chessa, F., Manca, A., Cottu, P., Fancellu, A. ... Madeddu, G. (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, 41, 483-489. https://doi.org/10.3892/ijo.2012.1495
MLA
Spanu, A., Sanna, D., Chessa, F., Manca, A., Cottu, P., Fancellu, A., Nuvoli, S., Madeddu, G."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 41.2 (2012): 483-489.
Chicago
Spanu, A., Sanna, D., Chessa, F., Manca, A., Cottu, P., Fancellu, A., Nuvoli, S., Madeddu, G."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 41, no. 2 (2012): 483-489. https://doi.org/10.3892/ijo.2012.1495