Retrospective and comparative analysis of 99mTc-Sestamibi breast specific gamma imaging versus mammography, ultrasound, and magnetic resonance imaging for the detection of breast cancer in Chinese women

BackgroundDiagnosing breast cancer during the early stage may be helpful for decreasing cancer-related mortality. In Western developed countries, mammographies have been the gold standard for breast cancer detection. However, Chinese women usually have denser and smaller-sized breasts compared to Caucasian women, which decreases the diagnostic accuracy of mammography. However, breast specific gamma imaging, a type of molecular functional breast imaging, has been used for the accurate diagnosis of breast cancer and is not influenced by breast density. Our objective was to analyze the breast specific gamma imaging (BSGI) diagnostic value for Chinese women.MethodsDuring a 2-year period, 357 women were diagnosed and treated at our oncology department and received BSGI in addition to mammography (MMG), ultrasound (US) and magnetic resonance imaging (MRI) for diagnostic assessment. We investigated the sensitivity and specificity of each method of detection and compared the biological profiles of the four imaging methods.ResultsA total of 357 women received a final surgical pathology diagnosis, with 168 malignant diseases (58.5 %) and 119 benign diseases (41.5 %). Of these, 166 underwent the four imaging tests preoperatively. The sensitivity of BSGI was 80.35 and 82.14 % by US, 75.6 % by MMG, and 94.06 % by MRI. Furthermore, the breast cancer diagnosis specificity of BSGI was high (83.19 % vs. 77.31 % vs. 66.39 % vs. 67.69 %, respectively). The BSGI diagnostic sensitivity for mammographic breast density in women was superior to mammography and more sensitive for non-luminal A subtypes (luminal A vs. non-luminal A, 68.63 % vs. 88.30 %).ConclusionsBSGI may help improve the ability to diagnose early stage breast cancer for Chinese women, particularly for ductal carcinoma in situ (DCIS), mammographic breast density and non-luminal A breast cancer.

[1]  N. Johnson,et al.  Breast-specific gamma imaging is a cost effective and efficacious imaging modality when compared with MRI. , 2014, American journal of surgery.

[2]  Su Jung Choi,et al.  Diagnostic Performance of Breast-Specific Gamma Imaging (BSGI) for Breast Cancer: Usefulness of Dual-Phase Imaging with 99mTc-sestamibi , 2013, Nuclear Medicine and Molecular Imaging.

[3]  N. Johnson,et al.  Real-world application of breast-specific gamma imaging, initial experience at a community breast center and its potential impact on clinical care. , 2008, American journal of surgery.

[4]  Hui Tan,et al.  Visual and semi-quantitative analyses of dual-phase breast-specific gamma imaging with Tc-99m-sestamibi in detecting primary breast cancer , 2013, Annals of Nuclear Medicine.

[5]  P. Meunier,et al.  Clinical utility of breast-specific gamma imaging for evaluating disease extent in the newly diagnosed breast cancer patient. , 2009, American journal of surgery.

[6]  Mark A. Helvie,et al.  Breast Cancer Screening and Diagnosis Clinical Practice Guidelines in Oncology. , 2006, Journal of the National Comprehensive Cancer Network : JNCCN.

[7]  Jamie E. Anderson,et al.  Comparing the National Surgical Quality Improvement Program With the Nationwide Inpatient Sample Database. , 2015, JAMA surgery.

[8]  Andres Forero,et al.  Breast Cancer Version 2.2015. , 2015, Journal of the National Comprehensive Cancer Network : JNCCN.

[9]  T. Heston,et al.  SNM Practice Guideline for Breast Scintigraphy with Breast-Specific γ-Cameras 1.0* , 2010, The Journal of Nuclear Medicine Technology.

[10]  Jianlun Liu,et al.  Clinical usefulness of breast-specific gamma imaging as an adjunct modality to mammography for diagnosis of breast cancer: a systemic review and meta-analysis , 2013, European Journal of Nuclear Medicine and Molecular Imaging.

[11]  Kenneth G A Gilhuijs,et al.  Current clinical indications for magnetic resonance imaging of the breast , 2014, Journal of surgical oncology.

[12]  Wanqing Chen,et al.  Female breast cancer incidence and mortality in 2011, China. , 2015, Journal of thoracic disease.

[13]  N. Hylton,et al.  Magnetic resonance imaging of the breast prior to biopsy. , 2004, JAMA.

[14]  Seong-Jang Kim,et al.  Comparison of quantitative and visual analysis of Tc-99m MIBI scintimammography for detection of primary breast cancer. , 2005, European journal of radiology.

[15]  Emily F Conant,et al.  Breast cancer screening using tomosynthesis in combination with digital mammography. , 2014, JAMA.

[16]  N. Dubrawsky.  Cancer statistics , 1989, CA: a cancer journal for clinicians.

[17]  M. Salvatore,et al.  99mTc-MIBI in the evaluation of breast cancer biology , 2004, European Journal of Nuclear Medicine and Molecular Imaging.

[18]  T. Canda,et al.  Correlation between 99mTc-MIBI uptake and angiogenesis in MIBI-positive breast lesions. , 2005, Nuclear medicine and biology.

[19]  R. Brem,et al.  Quantification of Radio‐tracer Uptake in Axillary Lymph Nodes using Breast Specific Gamma Imaging (BSGI): Benign Radio‐tracer Extravasation versus Uptake Secondary to Breast Cancer , 2009, The breast journal.

[20]  J. Lortet-Tieulent,et al.  Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society. , 2015, JAMA.

[21]  M. Tozaki,et al.  The Japanese Breast Cancer Society Clinical Practice Guideline for screening and imaging diagnosis of breast cancer , 2014, Breast Cancer.

[22]  R. Brem,et al.  Breast-specific gamma imaging as an adjunct modality for the diagnosis of invasive breast cancer with correlation to tumour size and grade. , 2012, The British journal of radiology.

[23]  Wendy B DeMartini,et al.  Background parenchymal enhancement on breast MRI: impact on diagnostic performance. , 2012, AJR. American journal of roentgenology.

[24]  Wanqing Chen,et al.  Breast cancer in China. , 2014, The Lancet. Oncology.

[25]  M. Pike,et al.  Mammographic density, MRI background parenchymal enhancement and breast cancer risk. , 2013, Annals of oncology : official journal of the European Society for Medical Oncology.

[26]  A. Miley,et al.  Breast-Specific γ-Imaging: Molecular Imaging of the Breast Using 99mTc-Sestamibi and a Small-Field-of-View γ-Camera* , 2009, Journal of Nuclear Medicine Technology.

[27]  Kyu-Tae Chang,et al.  Prognostic value of semi-quantitative tumor uptake on Tc-99m sestamibi breast-specific gamma imaging in invasive ductal breast cancer , 2015, Annals of Nuclear Medicine.

[28]  Seema A Khan,et al.  NCCN clinical practice guidelines in oncology: breast cancer screening and diagnosis. , 2009, Journal of the National Comprehensive Cancer Network : JNCCN.

[29]  K. Hergan,et al.  Added value of semi-quantitative breast-specific gamma imaging in the work-up of suspicious breast lesions compared to mammography, ultrasound and 3-T MRI. , 2015, The British journal of radiology.

[30]  K.P. Banks,et al.  Negative Predictive Value of Breast‐Specific Gamma Imaging in Low Suspicion Breast Lesions: A Potential Means for Reducing Benign Biopsies , 2011, The breast journal.

[31]  B. Moon,et al.  A comparative study of breast-specific gamma imaging with the conventional imaging modality in breast cancer patients with dense breasts , 2012, Annals of Nuclear Medicine.

[32]  Benjamin O. Anderson,et al.  Breast cancer version 2.2015: Clinical practice guidelines in oncology , 2015 .

[33]  A. Jemal,et al.  Cancer statistics, 2014 , 2014, CA: a cancer journal for clinicians.