Vol 3, No 2 (2000)
Published online: 2003-05-27
Submitted: 2012-01-23
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Diagnostic accuracy of mammography and scintimammography in detection of primary breast cancer related size of the tumour

Jarosław B. Ćwikła, John R. Buscombe, Slawomir Chaberek, Brian Holloway, Santilal Parbhoo, Andrew J.W. Hilson
Nucl. Med. Rev 2000;3(2):127-132.
Vol 3, No 2 (2000)
Published online: 2003-05-27
Submitted: 2012-01-23

Abstract

BACKGROUND: The detection of breast cancer relies on physical examination and mammography (XMM). The sensitivity of conventional imaging is lesions-size dependent. However, mammography has good sensitivity in small tumours when microcalcification is present, but the sensitivity is relatively low in other small tumours. The use of scintimammography with Tc-99m sestaMIBI (SMM) may be helpful in this situation. The aim of this study is to compare the diagnostic accuracy of mammography and scintimammography across all groups with different sizes of lesions.
METHODS: Data for 273 patients aged 26 to 84 years (mean 52; SD 12) with 298 lesions were analysed. All lesions were removed and final histology and pathological size of the tumours were retrospectively reviewed (mean size 2.9 cm, SD 2.4 cm). All patients had XMM and SMM. Each imaging study was graded using five grades of certainty. SMM images were reviewed by an independent specialist blinded to clinical presentation and XMM results. The diagnostic accuracy of each test, overall and by each lesions size subgroup, was compared using receiver operating characteristic curve (ROC) analysis.
RESULTS: The sensitivity of scintimammography was consistently high across all size groups; overall 89% (82?100%) compared with 68% (51?88%) for mammography. In those tumours below 2 cm, the area under the ROC was significantly larger with SMM than XMM (p < 0.05), with 80% certainty indicative of greater diagnostic accuracy. Also in all patients the area under the ROC was significantly larger with SMM than XMM (p < 0.05), with 90% certainty indicative of greater diagnostic accuracy. In other groups of lesions size the area under ROC for SMM was larger in lesions size between 2 and 4 cm and slightly smaller in lesions over 4 cm, but it was not significant.
CONCLUSION: Scintimammography using Tc-99m sestaMIBI seems to be a sensitive and consistently reliable diagnostic test for breast cancer independent of the size of the tumour.

Abstract

BACKGROUND: The detection of breast cancer relies on physical examination and mammography (XMM). The sensitivity of conventional imaging is lesions-size dependent. However, mammography has good sensitivity in small tumours when microcalcification is present, but the sensitivity is relatively low in other small tumours. The use of scintimammography with Tc-99m sestaMIBI (SMM) may be helpful in this situation. The aim of this study is to compare the diagnostic accuracy of mammography and scintimammography across all groups with different sizes of lesions.
METHODS: Data for 273 patients aged 26 to 84 years (mean 52; SD 12) with 298 lesions were analysed. All lesions were removed and final histology and pathological size of the tumours were retrospectively reviewed (mean size 2.9 cm, SD 2.4 cm). All patients had XMM and SMM. Each imaging study was graded using five grades of certainty. SMM images were reviewed by an independent specialist blinded to clinical presentation and XMM results. The diagnostic accuracy of each test, overall and by each lesions size subgroup, was compared using receiver operating characteristic curve (ROC) analysis.
RESULTS: The sensitivity of scintimammography was consistently high across all size groups; overall 89% (82?100%) compared with 68% (51?88%) for mammography. In those tumours below 2 cm, the area under the ROC was significantly larger with SMM than XMM (p < 0.05), with 80% certainty indicative of greater diagnostic accuracy. Also in all patients the area under the ROC was significantly larger with SMM than XMM (p < 0.05), with 90% certainty indicative of greater diagnostic accuracy. In other groups of lesions size the area under ROC for SMM was larger in lesions size between 2 and 4 cm and slightly smaller in lesions over 4 cm, but it was not significant.
CONCLUSION: Scintimammography using Tc-99m sestaMIBI seems to be a sensitive and consistently reliable diagnostic test for breast cancer independent of the size of the tumour.
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Keywords

breast cancer; Tc-99m sestaMIBI; scintimammography; mammography; receiver operating characteristic curve analysis (ROC)

About this article
Title

Diagnostic accuracy of mammography and scintimammography in detection of primary breast cancer related size of the tumour

Journal

Nuclear Medicine Review

Issue

Vol 3, No 2 (2000)

Pages

127-132

Published online

2003-05-27

Bibliographic record

Nucl. Med. Rev 2000;3(2):127-132.

Keywords

breast cancer
Tc-99m sestaMIBI
scintimammography
mammography
receiver operating characteristic curve analysis (ROC)

Authors

Jarosław B. Ćwikła
John R. Buscombe
Slawomir Chaberek
Brian Holloway
Santilal Parbhoo
Andrew J.W. Hilson

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