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Can scintimammography reduce "unnecessary" biopsies?
D A Flanagan1, S B Gladding, F R Lovell
1Department of General Surgery, Blodgett Memorial Medical Center, Grand Rapids, Michigan, USA.
The American Surgeon
|July 9, 1998
Summary
99Tc-sestamibi prone scintimammography (SMM) did not improve breast cancer diagnosis specificity in this study. Researchers do not recommend SMM as a screening tool to avoid biopsies due to its low negative predictive value.
Area of Science:
- Oncology
- Radiology
- Nuclear Medicine
Background:
- 99Tc-sestamibi prone scintimammography (SMM) is a novel, noninvasive breast tumor imaging technique.
- Previous pilot studies suggested SMM enhances mammography specificity, potentially reducing unnecessary biopsies.
Purpose of the Study:
- To prospectively evaluate the efficacy of SMM as an adjunct to conventional mammography for diagnosing breast carcinoma.
- To determine if SMM can effectively reduce the number of mammographically indicated breast biopsies.
Main Methods:
- Prospective case series design with patients serving as their own controls.
- Inclusion criteria: abnormal mammogram, palpable breast mass, or both.
- All participants underwent clinical breast examination, conventional mammography, SMM, and subsequent breast biopsy.
Main Results:
- The study evaluated 80 lesions in 79 women.
- SMM demonstrated a sensitivity of 81%, specificity of 81%, positive predictive value of 61%, and negative predictive value of 92%.
- These performance metrics were significantly lower than those reported in a prior pilot study.
Conclusions:
- SMM did not increase the specificity of conventional mammography in this patient cohort.
- The negative predictive value of SMM was found to be low.
- SMM is not recommended as a screening technique for avoiding breast biopsies.