Tc-99m sestamibi scintimammography in the mammographically dense breast

The mammographically dense breast or the "difficult-to-interpret mammogram" poses significant clinical and diagnostic imaging concerns. From our experience using Tc-99m sestamibi mammography in more than 650 patients, we share our experience in a pictorial manner and include suggested indications and limitations of this exciting new technique. Examples of Tc-99m sestamibi imaging in six patients with mammographically dense breasts are presented.

All patient examinations were ordered clinically for various indications. Comparison radiographic mammography and, when available, confirmatory pathologic analysis were also done. The examples were chosen from our experience with more than 650 patients at two university hospitals and one outpatient imaging center.

Of the six examples presented, four had cancer, one had fibrosis after chemotherapy for ductal cell carcinoma, and one had no evidence of cancer. Tc-99m sestamibi imaging showed no increased uptake in the one patient with no tumor and various degrees of uptake in the other five patients.

Six examples from our clinical experience show the usefulness of Tc-99m sestamibi imaging in patients with mammographically dense breasts. The ability to identify a malignancy or its absence supports the continued use of this procedure in these patients.