Correlation between MAMMI-PET findings and anatomopathological outcomes in breast cancer patients

Imaging tests are a key element in the preoperative diagnosis of patients with breast cancer. Whole-body PET-computed tomography (PET/CT) breast studies have a limited spatial resolution, although dedicated breast PET (dbPET) devices such as the Mammography with Molecular Imaging PET (MAMMI-PET), have an increased sensitivity to detect tumor foci, especially those smaller than 2 cm. The purpose of this study is to define the validity and reliability of this new device.

A prospective and analytical observational study was carried out in a sample of patients with histologically confirmed breast cancer who were treated at our hospital between January 2017 and November 2018. The anatomopathological study findings for the surgical pieces were used as gold standards and we calculated their concordance with the findings from the MAMMI-PET as well as the validity and reliability parameters for this test.

Data from 32 patients and 44 lesions (36 malignant and 8 benign) were evaluated. The mean patient age was 51.50 ± 11.68 years. Twenty patients had received neoadjuvant chemotherapy (NACT). The technique concordance rate was weak ( K  = 0.349, P  = 0.001) and was 84.3% for benign lesions and 62.6% for malignant ones. The MAMMI-PET sensitivity was 75%, whereas its specificity was 57.1%; the positive predictive value was 81.8% and the negative predictive value was 47.1%, with an overall precision of 70%. The MAMMI-PET sensitivity was higher in patients who had not undergone NACT and was significantly higher in patients with luminal B breast cancer compared to the luminal A subtype.

The MAMMI-PET device had acceptable sensitivity and a high positive predictive value for the preoperative evaluation of patients with breast cancer; it was especially useful for lesions whose diagnosis with other imaging tests had been doubtful.