Scintimammography with a high resolution dedicated breast camera in comparison with SPECT/CT in primary breast cancer detection

AIM: We evaluated the usefulness of planar scintimammography (SM) with a high resolution dedicated breast camera (DBC) in comparison with single photon emission computed tomography (SPECT)/computed tomography (CT) in primary breast cancer detection. METHODS: A consecutive series of 157 patients with breast lesions suspicious for cancer at conventional diagnostic procedures were studied with both DBC planar SM and SPECT/CT using [99mTc]tetrofosmin as radiotracer. Scintigraphic data have been related with definitive histopathological findings in all cases. RESULTS: Breast cancer was ascertained in 127/157 patients and benign disease in the remaining 30 cases, with a total of 140 carcinomas and 33 benign lesions. DBC planar SM detected 95.7% of overall carcinomas, while SPECT/CT 90.7% (P<0.01). In =or<10 mm carcinomas, sensitivity was 89.1% for DBC planar SM and 78.3% for SPECT/CT (P<0.05); in carcinomas >10 mm the corresponding values were 98.9% and 96.8%, respectively. Specificity value was 87.9% for both procedures; accuracy value was 94.2% for DBC and 90.2% for SPECT/CT (P<0.01). Forty-six out of 127 breast cancer patients had axillary lymph node metastases; SPECT/CT was positive in 36/46 (78.3%) cases and showed a 96.4% specificity value. DBC planar SM identified metastases in only 4 cases. CONCLUSIONS: DBC planar SM proved a useful diagnostic method in primary breast cancer detection, showing significantly higher sensitivity and accuracy values than SPECT/CT, especially in small size carcinomas. Thus, DBC planar SM should be preferred, although SPECT/CT, given its high performance, could represent a useful alternative when DBC is not available. Moreover, SPECT/CT, but not DBC, can contribute to providing information on axillary lymph node status.