Background: To systematically review the performance of scintimammo-graphy compared with mammography in detecting breast lesions.
Methods: A literature search was performed in PubMed and ScienceDirect databases with “scintimammography AND breast lesions,” “mammography AND breast lesions,” “diagnostic value,” and “accuracy” as keywords to identify all related studies published in English from January 1, 2000, to August 1, 2017. Twenty-five studies, with a total of 4094 patients with clinically suspicious breast lesions, were included in the final analysis to assess the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of scintimammography vs. mammography in detecting breast lesions.
Results: The sensitivity and specificity of mammography were 75.82 ± 10.53 (95% confidence interval [CI], 50-84) and 59.58 ± 22.79 (95% CI, 20-91.4), respectively. The PPV and NPV of mammography were 75.60 ± 2.21 (95% CI, 42-93) and 61.62 ± 1.67 (95% CI, 39.1-86), respectively. The sensitivity of scintimammography was 86.64 ± 8.84 (95% CI, 58.3-100), and the specificity was 83.42 ± 10.74 (95% CI, 60-100). The PPV and NPV of scintimammography were 82.10 ± 11.65 (95% CI, 58-98.30) and 81.02 ± 17.00 (95% CI, 45-100), respectively.
Conclusions: Although mammography has a high sensitivity in the examination of older patients with fatty breast tissue, it is less reliable in detecting breast lesions in young and premenopausal patients with dense breasts. Diagnostic accuracy of scintimammography, as a functional imaging modality, is not affected by breast density, contrary to mammography. Therefore, scintimammography can improve the specificity of mammography.
Full text article
Pan L, Han Y, Sun X, Liu J, Gang H. FDG-PET and other imaging modalities for the evaluation of breast cancer recurrence and metastases: a meta-analysis. J Cancer Res Clin Oncol. 2010;136(7):1007-22.
Pennant M, Takwoingi Y, Pennant L, Davenport C, Fry-Smith A, Eisinga A, et al. A systematic review of positron emission tomography (PET) and positron emission tomography/computed tomography (PET/CT) for the diagnosis of breast cancer recurrence. Health Technol Assess. 2010;14(50):1-103.
Warning K, Hildebrandt MG, Kristensen B, Ewertz M. Utility of 18FDG-PET/CT in breast cancer diagnostics--a systematic review. Dan Med Bull. 2011;58(7):A4289.
Heydarheydari S, Haghparast A. Diagnostic Value of PET/CT in Comparison with Other Conventional Imaging Modalities for the Evaluation of Breast Cancer Recurrence: A Systematic Review of the Literature. Archives of Breast Cancer. 2016;3(3):77-82.
Helvie MA, Chang JT, Hendrick RE, Banerjee M. Reduction in late-stage breast cancer incidence in the mammography era: Implications for overdiagnosis of invasive cancer. Cancer. 2014;120(17):2649-56.
Hall FM. Screening mammography—potential problems on the horizon. Mass Medical Soc; 1986.
Brem RF, Tabár L, Duffy SW, Inciardi MF, Guingrich JA, Hashimoto BE, et al. Assessing improvement in detection of breast cancer with three-dimensional automated breast US in women with dense breast tissue: the SomoInsight Study. Radiology. 2014;274(3):663-73.
PRESSMAN PI. Delayed diagnosis of breast cancer as a result of normal mammograms. Archives of Surgery. 1983;118(8):992-.
Sickles EA. Mammographic features of 300 consecutive nonpalpable breast cancers. AJR Am J Roentgenol. 1986;146(4):661-3.
Moriguchi SM, LA DEL, Griva BL, Koga KH, ET DAS, H DELV, et al. Accuracy of (99m)Tc-sestamibi scintimammography for breast cancer diagnosis. Exp Ther Med. 2010;1(1):205-9.
Campeau RJ, Kronemer KA, Sutherland CM. Concordant uptake of Tc-99m sestamibi and Tl-201 in unsuspected breast tumor. Clin Nucl Med. 1992;17(12):936-7.
Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Annals of internal medicine. 2011;155(8):529-36.
Chen S, Liu W, Mao Y, Zhu W, Yao Z, Sun X, et al. 99mTc-MIBI and 99mTc-MDP scintimammography for detecting breast carcinoma. Chin Med J (Engl). 2000;113(5):400-3.
Prats E, Banzo J, Merono E, Herranz R, Carril J. 99mTc-MIBI scintimammography as a complement of the mammography in patients with suspected breast cancer. A multicentre experience. The Breast. 2001;10(2):109-16.
Yildiz A, Colak T, Gungor F, Ozugur S, Boz A, Tuncdemir F, et al. Diagnostic value of 99mTc MIBI scintimammography in patients with breast lesions. Rev Esp Med Nucl. 2001;20(4):276-81.
Koukouraki S, Koukourakis M, Vagios E, Velidaki A, Tsiftsis D, Karkavitsas N. The role of 99mTc-sestamibi scintimammography and colour Doppler ultrasonography in the evaluation of breast lesions. Nuclear medicine communications. 2001;22(11):1243-8.
Aguilar J, Andrés B, Nicolás F, Muelas M, Pérez-Flores D, Aguayo JL. Value of 99mTc-MIBI scintimammography in women with impalpable breast lesions seen on mammography. The European journal of surgery. 2001;167(5):344-6.
Horne T, Pappo I, Cohen-Pour M, Baumer M, Orda R. 99Tcm-tetrofosmin scintimammography for detecting breast cancer: a comparative study with 99Tcm-MIBI. Nuclear medicine communications. 2001;22(7):807-11.
Bagni B, Franceschetto A, Casolo A, De Santis M, Bagni I, Pansini F, et al. Scintimammography with 99mTc-MIBI and magnetic resonance imaging in the evaluation of breast cancer. Eur J Nucl Med Mol Imaging. 2003;30(10):1383-8.
Sampalis FS, Denis R, Picard D, Fleiszer D, Martin G, Nassif E, et al. International prospective evaluation of scintimammography with 99mTechnetium sestamibi. The American journal of surgery. 2003;185(6):544-9.
Myslivecek M, Koranda P, Kaminek M, Husak V, Hartlova M, Duskova M, et al. Technetium-99m-MIBI scintimammography by planar and SPECT imaging in the diagnosis of breast carcinoma and axillary lymph node involvement. Nucl Med Rev Cent East Eur. 2004;7(2):151-5.
Fondrinier E, Muratet JP, Anglade E, Fauvet R, Berger V, Lorimier G, et al. Clinical experience with 99mTc-MIBI scintimammography in patients with breast microcalcifications. Breast. 2004;13(4):316-20.
De Cicco C, Trifiro G, Baio S, Sierra ML, Pizzamiglio M, Cassano E, et al. Clinical utility of 99mTc-Sestamibi scintimammography in the management of equivocal breast lesions. Cancer Biother Radiopharm. 2004;19(5):621-6.
Kim SJ, Kim IJ, Bae YT, Kim YK, Kim DS. Comparison of quantitative and visual analysis of Tc-99m MIBI scintimammography for detection of primary breast cancer. Eur J Radiol. 2005;53(2):192-8.
Prats E, Razola P, Sainz J, Tardín L, Andrés A, Abós M, et al. Scintimammography with 99mTc-MIBI in clinical practice. Repercussion on the clinical management of the patient. Revista española de medicina nuclear (English Edition). 2007;26(3):153-9.
Usmani S, Khan HA, Javed A, Al Mohannadi S, Al Huda FA, Al Shammary I. Functional breast imaging with Tc 99m Mibi for detection of primary breast lesion and axillary lymph node metastases. Gulf J Oncolog. 2008(4):52-7.
Habib S, Maseeh uz Z, Hameed A, Niaz K, Hashmi H, Kamal S. Diagnostic accuracy of Tc-99m-MIBI for breast carcinoma in correlation with mammography and sonography. J Coll Physicians Surg Pak. 2009;19(10):622-6.
DeCesare A, De Vincentis G, Gervasi S, Crescentini G, Fiori E, Bonomi M, et al. Single-photon-emission computed tomography (SPECT) with technetium-99m sestamibi in the diagnosis of small breast cancer and axillary lymph node involvement. World J Surg. 2011;35(12):2668-72.
Hoi Y, Hsieh J, Tsai S, Sun S, Kao C. Usefulness of technetium-99m tetrofosmin mammoscintigraphy as compared to mammography for detecting and differentiating palpable breast masses of young Taiwanese women. Anticancer research. 2000;20(3B):2061-4.
Chen D, Jeng L, Kao A, Lin C, Lee C. Usefulness of mammoscintigraphy with thallium-201 single photon emission computed tomography to differentiate palpable breast masses of young Taiwanese women when comparing with mammography. Neoplasma. 2002;49(5):334-7.
Kotsianos-Hermle D, Hiltawsky KM, Wirth S, Fischer T, Friese K, Reiser M. Analysis of 107 breast lesions with automated 3D ultrasound and comparison with mammography and manual ultrasound. Eur J Radiol. 2009;71(1):109-15.
Mulero F, Nicolas F, Castellon MI, Fuentes T, de la Cruz P, Roca V, et al. [99m Tc-MIBI scintigraphy compared to mammography in the diagnosis of breast cancer in dense, operated and young women breasts]. Rev Esp Med Nucl. 2000;19(5):344-9.
Sun S, Hsieh J, Tsai S, Ho Y, Lee J, Kao C. The role of Tc-99m methoxyisobutylisonitrile scintimammography as compared to mammography in evaluating palpable breast masses of Taiwanese women. Anticancer research. 2000;20(3B):2133-6.
Lumachi F, Ferretti G, Povolato M, Marzola MC, Zucchetta P, Geatti O, et al. Accuracy of technetium-99m sestamibi scintimammography and X-ray mammography in premenopausal women with suspected breast cancer. Eur J Nucl Med. 2001;28(12):1776-80.
Cwikła J, Buscombe J, Kolasińska A, Holloway B, Hilson A. Evaluation of scintimammography as an additional test to conventional mammography in detection of breast cancer. Ginekologia polska. 2003;74(5):362-70.
Krishnaiah G, Sher-Ahmed A, Ugwu-Dike M, Regan P, Singer J, Totoonchie A, et al. Technetium-99m sestamibi scintimammography complements mammography in the detection of breast cancer. Breast J. 2003;9(4):288-94.
Ozülker T, Ozülker F, Ozpaçaci T, Bender O, Değirmenci H. The efficacy of (99m) Tc-MIBI scintimammography in the evaluation of breast lesions and axillary involvement: a comparison with X-rays mammography, ultrasonography and magnetic resonance imaging. Hellenic journal of nuclear medicine. 2010;13(2):144-9.
Kimme-Smith C, Wang J, DeBruhl N, Basic M, Bassett LW. Mammograms obtained with rhodium vs molybdenum anodes: contrast and dose differences. AJR Am J Roentgenol. 1994;162(6):1313-7.
Omar WS, Eissa S, Moustafa H, Farag H, Ezzat I, Abdel-Dayem HM. Role of thallium-201 chloride and Tc-99m methoxy-isobutyl-isonitrite (sestaMIBI) in evaluation of breast masses: correlation with the immunohistochemical characteristic parameters (Ki-67, PCNA, Bcl, and angiogenesis) in malignant lesions. Anticancer Res. 1997;17(3B):1639-44.
Tierney S, Fenlon H, Phelan N, O'sullivan P, Ennis J, Gorey T. Scintimammography in the assessment of local recurrence following conservative breast surgery. The British Journal of Surgery-Supplement. 1998;85:51.
Cutrone JA, Khalkhali I, Yospur LS, Diggles L, Weinberg I, Pong EM, et al. Tc-99m Sestamibi Scintimammography for the Evaluation of Breast Masses in Patients with Radiographically Dense Breasts. Breast J. 1999;5(6):383-8.
Zegel H, Heller L, Edell S, Squires F, Rubin J. Tc-99m sestamibi scintimammography in the mammographically dense breast. Clin Nucl Med. 1999;24(12):968-74.
Kolasinska A, Cwikla J, Buscombe J, Parbhoo S, Davidson T, Holloway B, et al. 63. Scintimammography in recurrent breast cancer: A primary or secondary role? Nuclear Medicine Communications. 2000;21(4):389.
Kuhn JC, Siegel A, Poplack S, Arrick B. Chest wall recurrence of breast cancer detected by scintimammography. Clin Nucl Med. 2000;25(2):104-6.
Usmani S, Khan HA, Niaz K, Uz-Zaman M, Niyaz K, Javed A, et al. Tc-99m-methoxy isobutyl isonitrile scintimammography: imaging postexcision biopsy for residual and multifocal breast tumor. Nuclear medicine communications. 2008;29(9):826-9.
Fliquete MP, Giménez JC, Vázquez CF, Más CA, Vázquez CA. Role of 99mTc-Sestamibi in the diagnosis of breast cancer. Report on 100 cases. Revista espanola de medicina nuclear. 1999;18(6):436-41.
Tofani A, Sciuto R, Semprebene A, Festa A, Pasqualoni R, Giunta S, et al. 99Tcm-MIBI scintimammography in 300 consecutive patients: factors that may affect accuracy. Nuclear medicine communications. 1999;20(12):1113-21.
Bekis R, Derebek E, Balci P, Kocdor MA, Degirmenci B, Canda T, et al. 99mTc sestamibi scintimammography. Screening mammographic non-palpable suspicious breast lesions: preliminary results. Nuklearmedizin. 2004;43(1):16-20.
Palmedo H, Biersack H, Lastoria S, Maublant J, Prats E, Stegner H, et al. Scintimammography with technetium-99m methoxyisobutylisonitrile: results of a prospective European multicentre trial. European journal of nuclear medicine. 1998;25(4):375-85.
Palmedo H, Schomburg A, Grunwald F, Mallmann P, Krebs D, Biersack H-J. Technetium-99m-MIBI scintimammography for suspicious breast lesions. Journal of Nuclear Medicine. 1996;37(4):626-30.
Wilczek B, Aspelin P, Bone B, Pegerfalk A, Frisell J, Danielsson R. Complementary use of scintimammography with 99m-Tc-MIBI to triple diagnostic procedure in palpable and non-palpable breast lesions. Acta Radiol. 2003;44(3):288-93.
Brem RF, Schoonjans JM, Kieper DA, Majewski S, Goodman S, Civelek C. High-resolution scintimammography: a pilot study. J Nucl Med. 2002;43(7):909-15.
Kim BS, Moon BI, Cha ES. A comparative study of breast-specific gamma imaging with the conventional imaging modality in breast cancer patients with dense breasts. Ann Nucl Med. 2012;26(10):823-9.
Khalkhali I, Cutrone J, Mena I, Diggles L, Venegas R, Vargas H, et al. Technetium-99m-sestamibi scintimammography of breast lesions: clinical and pathological follow-up. J Nucl Med. 1995;36(10):1784-9.
Taillefer R, Robidoux A, Lambert R, Turpin S, Laperrière J. Technetium-99m-sestamibi prone scintimammography to detect primary breast cancer and axillary lymph node involvement. Journal of Nuclear Medicine. 1995;36(10):1758-65.
Copyright (c) 2018 Archives of Breast Cancer
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright©. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International License, which permits copy and redistribution of the material in any medium or format or adapt, remix, transform, and build upon the material for any purpose, except for commercial purposes.