Mammaszintigraphie als Surrogatmethode zur Differenzierung mammographisch unklarer Läsionen
| Autor: | Harald Sommer, K. Hahn, L. Friedl, M. Hoernstein, D. Heiss, B. Camerer, G. Kindermann, F. Willgeroth, Reinhold Tiling, S. Hatzinger |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Breast biopsy
medicine.medical_specialty medicine.diagnostic_test business.industry Obstetrics and Gynecology Physical examination Gold standard (test) Scintigraphy medicine.disease Inflammatory breast cancer Radiological weapon Maternity and Midwifery medicine Mammography Radiology Nuclear medicine business Pathological |
| Zdroj: | Geburtshilfe und Frauenheilkunde. 59:12-18 |
| ISSN: | 1438-8804 0016-5751 |
| DOI: | 10.1055/s-1999-14154 |
| Popis: | Background: Mammography is the gold standard of breast diagnostics. Completely new radiological developments are not to be expected in the near future. Thus, additive methods for mammography such as sonography, Doppler sonography, MRI, and scintigraphy are being increasingly employed. In this study, the mammography findings were compared with breast scintigraphy to define the limitations of both methods. The goal of the employing additional diagnostical methods besides mammography is to reduce the number of open biopsies. Patients and Methods: The histological findings of 1206 breast operations (in 1035 women) were analysed retrospectively. The indication to operate was based on a pathological mammographic or clinical finding. One hundred and forty patients with unclear mammographic findings were subjected to additional breast scintigraphy with 99 m Technetium prior to the planned operations. Results: In 619 operations, a malignant diagnosis was obtained (51.3%); the other 587 operations resulted in benign findings (48.7%). This is about a 1:1 ratio of benign to malignant final diagnosis from the operative breast biopsy. Histological benign findings included 242 (41.2%) fibrotic-cystic mastopathies and 168 (28.8%) fibroadenomas. These findings had been detected by mammography or clinical examination, but could not be clearly defined as benign and thus resulted in the necessity to operate. The additive implementation of breast scintigraphy resulted in a pre-operative diagnosis of 32 of 34 histologically confirmed mastopathic findings. The additive scintigraphy also resulted in a pre-operative diagnosis of 8 of 11 histologically confirmed fibroadenomas. The results of the breast scintigraphy thus had a higher specificity of 86% compared to normal mammography (specificity 47.9%); the sensitivity, however, was lower (79%) than that of mammography (90%). The results of breast scintigraphy for therapy monitoring of women with inflammatory breast cancer who received primary chemotherapeutic treatment correlated well with the clinical signs of remission and histological findings. Mammography and MRI failed to be of use in these cases. Conclusions: The enthusiastic reports from the USA concerning breast scintigraphy e.g. including suggestions on its implementation as a diagnostic method alone without mammography, cannot be confirmed as yet by German studies. Scintigraphy is still too new compared to the well-established mammography, so that experience an using this method must still be gained. However, breast scintigraphy is a useful complementary method for interdisciplinary breast diagnostics and may lead to a reduction of the necessity for ,,open biopsies. |
| Databáze: | OpenAIRE |
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