Elsevier

Academic Radiology

Volume 17, Issue 6, June 2010, Pages 735-743
Academic Radiology

Original Investigation
Detection of Occult Foci of Breast Cancer Using Breast-Specific Gamma Imaging in Women with One Mammographic or Clinically Suspicious Breast Lesion

https://doi.org/10.1016/j.acra.2010.01.017Get rights and content

Rationale and Objectives

The aim of this study was to determine how often breast-specific gamma imaging (BSGI) identifies occult cancerous lesions in women with one suspicious lesion detected on mammography or physical exam.

Materials and Methods

A retrospective review was performed of the records of all patients who underwent BSGI between January 1, 2004, and June 4, 2007. Included in the study were 159 women who had one suspicious breast lesion on physical exam and/or mammography and who underwent BSGI to evaluate for occult lesions in the breast. All patients had one or more foci of cancer proven pathologically. BSGI findings were classified as normal or abnormal on the basis of the presence of focal radiotracer uptake.

Results

BSGI detected additional suspicious lesions occult to mammography and physical exam in 46 of 159 women (29%). BSGI identified occult cancer in 14 of 40 women (35%) who underwent biopsy or excision because of BSGI findings and in 14 of the 159 (9%) women in this study. In nine women, the occult cancer was present in the same breast as the index lesion (6%), and in five women, the occult cancer was found in the contralateral breast (3%).

Conclusions

BSGI is an effective imaging modality in the identification of mammographically and clinically occult cancer in women with one suspicious breast lesion.

Section snippets

Subjects

A retrospective review was performed of the records of all patients who underwent BSGI from January 1, 2004, through June 4, 2007. Among these, 159 women met the following criteria: (1) one suspicious breast lesion was found on physical exam and/or mammography, (2) BSGI was performed to evaluate for occult cancerous lesions in the breasts, and (3) the patient was proven by pathology to have one or more foci of breast cancer. Institutional review board approval and Health Insurance Portability

Baseline Characteristics

One hundred fifty-nine women with one suspicious lesion on physical exam or mammography who underwent BSGI were included. Sixty-two of the women (39%) were premenopausal and 97 (61%) were postmenopausal. Nineteen of these women (12%) had personal histories of breast cancer. Family histories of breast cancer were present in 68 women (43%), of whom 35 women had family histories of breast cancer in first-degree relatives. One woman was adopted, and her family history was unknown.

The Breast Imaging

Discussion

The detection of multifocal, multicentric, and bilateral breast cancer is important because it alters the surgical management of the patient (28). The identification of all foci of breast cancer is a critical component of optimal patient care. BSGI is a novel, physiologically based adjunct imaging modality for the diagnosis of breast cancer that is increasingly being used. BSGI has been shown to reliably detect breast cancers, including subcentimeter cancers, as well as difficult-to-detect

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