The Value of Scintimammography in Reduction Mammaplasties: A Preliminary Study

Abstract

Reduction mammaplasty results in architectural distortion, fat necrosis, and heavy scarring of the breast. In such conditions, mammography (MG) might not be reliable and an alternative unfailing imaging technique is demanded to prevent unnecessary apprehension and biopsy. With this study, the value of Tc-99m sestamibi (MIBI) scintimammography (SCM) as an adjunct test after reduction mammaplasty was explored. MIBI scintigraphy is not affected by scar tissue or breast density and is able to differentiate benign and malignant lesions. The study was conducted on 12 women undergoing a reduction mammaplasty operation (McKissock technique). The average age was 38 and the average weight of breast tissue removed from each breast was 320 g. All patients, except one who was 21 years old, underwent MG and SCM preoperatively, and these tests were repeated at the sixth postoperative month. Preoperative MG and SCM revealed no pathology except a finding in one patient consistent with fibroadenoma. Postoperatively, the most common findings in MG were parenchymal redistribution, elevation of the nipple, and retroareolar fibrotic bands. Calcifications and oil cysts were not seen. Other findings were areola and skin thickening. Interestingly, these findings were not evident on the SCM, in fact it was not possible to state whether or not the breast had been operated on. In conclusion, SCM may not be used as screening test, but it should be considered when the postoperative MG is not informative or is complicated by scaring. In this condition, SCM may be used as a complementary method to MG and may help to prevent unnecessary breast biopsies.

Molecular Imaging in Breast Cancer – Potential Future Aspects

“…In comparison with mammography, the sensitivity of 99mTc sestamibi scintimammography is independent of breast density [8][9][10]. In addition, scintimammography has not shown increased uptake in women with architectural distortion or scarring from a prior procedure [11]. 99mTc sestamibi scintimammography performed with a general-purpose gamma camera is limited by the inability to reliably image cancers smaller than 1 cm, owing to its intrinsic resolution with a sensitivity for these lesions of 35-65% [12][13][14][15][16][17].…”