بررسي ارزش تشخيصي اسكن Scintimammograph 99MTC-MIBI در بدخيمي هاي پستان

The breast cancer is common In females.Early detection with safe , convenient , noninvasive and accessible diagnostic tools are important. X-ray mammography is still the first choice imaging for breast cancer, but has low specificity and limited value in dense breast and surgically scarred breasts. In recent years , MIBI scintimammography has been used for this purpose. The aim of this study was to determine diagnostic value of prone lateral 99mTc-MIBI scintigraphy in detection of primary breast cancer in patients with breast lesions. We evaluated 55 patients with breast lesions and/or suspicious mammographic findings with MIBI scintimammography. In all patients , the diagnosis was established by pathology. Pattern of MIBI uptake and ratio of lesion to normal tissue uptake was recorded. All lesions with focal uptake and T/N ratio of more than 1.31 were considered as positive. Absence of focal activity or diffuse uptake either unilaterally or bilaterally were considered negative for malignancy. Focal uptake with TIN ratio of 1.01-1.30 was equivocal in MIBI scan. Mammographic and sonographic findings were classified as negative ( normal or benign) , equivocal and Positive (suspicious for malignancy or strongly malignant). Of 55 patients , 10 had cancer in pathologic examination. The MIBI scan detected all of the 10 cancerous lesions. X-mammography was positive in 6 of 10 patients and was negative or equivocal in 3 of them. In this study the MIBI breast scintimammography showed sensitivity and specificity of 100% and 95.4%. With respect to the limitations of X-ray mammography particularly in the young females , dense breasts and surgically scarred breasts , and low specificity of it , MIBI scan can be used as complementary imaging to the mammography and sonography in the evaluation of the breast lesions.