The efficacy of SPECT-CT with 99mTc-MIBI for detecting axillary lymph node (LN) involvement was evaluated in 184 patients with primary breast cancer. All patients were operated with histological examination of axillary LNs. During statistical analysis we determined correlation between LN metastases and various diagnostic and clinical characteristics. SPECT-CT signs of LN involvement were as follows: short axis more than 10 mm, cortical thickness more than 4mm, solid structure, round shape, intensive tracer uptake. More than 2 metastatic LNs were considered as plural metastatic damage. The complex model for evaluation axillary LN involvement was elaborated. The use this data in our study showed that SPECT-CT 99mTc-MIBI could correctly exclude 2 or more metastatic LNs in 96% breast cancer patients.
In 437 primary patients with breast cancer (BC) we compared diagnostic accuracy of mammography (MG) and mammoscintigraphy (MCG) with 99mTc-MIBI. All women, included in the study, had lesions suspicious for BC. In 108 suspicious lesions were less than 10 mm in diameter. On histology 33 (30,5%) patients had invasive BC, 20 (18,5%) - noninvasive BC, 6 (5,6%) - lobular carcinoma, 2 (1,9%) - mucinous BC, 8 (7,4%) - fibroadenoma and in remained 39 cases (36,1%) - localised fibrosis. In the group of women with lesions below 10 mm sensitivity, specificity and accuracy of MG in diagnosis of BC were 72%, 74%, 73%, for MCG - 62%, 51%, 57%. Combination of MG and MCG helped to increase sensitivity to 93,4%. In 53 women with dense breasts sensitivity, specificity and accuracy of MG were 40%, 71,4%, 64%; for mCg two times higher (82%) with specificity of 55% and 60% accuracy. Combination of MG and MCG allowed increasing the sensitivity of diagnosis of minimal BC 2 times more (up to 91%).
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