Scintimammography with 99mTc-MIBI in clinical practice. Repercussion on the clinical management of the patient

Autor: P. Razola, L. Tardín, J.M. Sainz, A. Andrés, J. Fernandez, M.D. Abós, Flávio Roberto Mello Garcia, J. Banzo, L. Villavieja, E. Prats
Rok vydání: 2007
Předmět:
Zdroj: Revista Española de Medicina Nuclear (English Edition). 26:153-159
ISSN: 1578-200X
DOI: 10.1016/s1578-200x(07)70056-6
Popis: Objective Establish the usefulness of scintimammography (SM) in day-to-day clinical practice. Material and methods We have evaluated 308 SM consecutively performed in our Department. The diagnosis was established by way of biopsy or clinical and mammography follow-up (minimum 18 months). In all cases we evaluated the kind of lesions (palpable or non-palpable) and their degree of suspicion of malignancy in the mammography (BIRADS). We determined the number of fine-needle aspiration cytology (FNAC) or biopsies performed in dependence of kind of lesions, mammography and SM results. Results Final diagnosis was cancer in 18 % of the patients, and 71 % of the lesions were non palpable. Negative predictive value (NPV) of SM was 96 %. Pathological diagnosis was performed in 100 % of lesions with SM+ and 16 % of lesions with SM–. According to the kind of lesion, FNAC and/or biopsy was performed in 62 % of palpable lesions and in 20 % of non-palpable lesions; and according to the mammography in 21 % of lesions BIRADS I-II, 14 % in BIRADS III, 70 % in BIRADS IV and 100 % in BIRADS V. The number of FNAC and/or biopsies performed is significantly higher in all cases when SM is positive (p >0.001), excepting in BIRADS V lesions. Conclusions In day-to-day clinical practice SM is generally performed in low prevalence of breast cancer population, in the evaluation of non-palpable lesions with a low suspicion of malignancy. SM has a high NPV, increase the diagnostic accuracy of the mammography and has repercussion on patient management, except in BIRADS V lesions.
Databáze: OpenAIRE