The role of nuclear medicine in breast cancer detection: A focus on technetium-99 sestamibi scintimammography

Abstract

Screening mammography in women aged over 50 years reduces breast cancer death by 30%. However, because mammography cannot accurately differentiate benign from malignant lesions, many mammography-directed breast biopsies are benign. In the past decade, methods of "functional breast imaging," including magnetic resonance imaging, scintimammography using single photon emission tomography, and positron emission tomography, have improved the sensitivity and specificity rates of conventional mammography for the detection of breast cancer. The higher specificity of scintimammography is feeding current enthusiasm for the study of its role in early breast cancer detection, as a complement to mammography in the evaluation of indeterminate lesions, and for use in noninvasive axillary staging. This article reviews the applications of radionuclide technology in breast cancer diagnosis and surveillance.

Are there differences in Breast Tissue as a Result of Hormone Replacement Therapy? Can BEST Imaging Distinguish these Differences?

“…Evaluation of the transition in anatomic change is limited by an inability to evaluate these metabolic changes. Nuclear imaging of the breast using isotopes can be used to look at the metabolic function of cells by employing isotopes that are taken up by the mitochondria [1][2][3][4][5][6] of breast cells and by detecting changes in blood flow 6,7 present with increased vascularity resulting from vascular endothelial growth factors. Such approaches can even be used to determine the effectiveness of chemotherapy 8 treatment.…”

Incidental PET/CT Detection of Breast Cancer in a Patient with Negative Mammogram and Breast Sonogram

“…However, these conventional methods have diagnostic limitations. 20% of palpable breast cancers are not detectable with mammography [ 2 ] and it has been shown to have a low positive predictive value (ranges from 5 to 40%) [ 3 ], especially in patients with implants or who have undergone prior treatment for breast cancer [ 4 ] To help overcome these deficiencies, imaging techniques such as MRI, PET, magnetic resonance mammography [ 5 ] and scintimammography [ 6 ] are receiving attention.…”

Male breast uptake of 99m-Tc sestamibi in myocardial perfusion imaging

“…When increased tracer uptake is seen in the breast or lung regions, a high incidence of malignancy has been reported [3]. Tc-99m sestamibi scintimammography has been approved by the Food and Drug Administration for the detection of breast cancer [4] although increased focal tracer uptake of sestamibi can also be seen with benign causes, such as hematomas [5]. There are case reports of identifying breast cancer in female patients as an incidental finding during SPECT imaging [6], but there are no known prior reports of diagnosing either breast cancer or gynecomastia in men using the technique.…”