Breast cancer detection with sestamibi-Tc-99m and Tl-201 radionuclides in patients with non conclusive mammography

Early diagnosis of breast cancer using breast examination, mammography and ultrasonography is highly accurate, but radiologically dense breast represent a challenge for the mammographic detection of early stage tumors. The aim of this study is to determine the clinical value of scintigraphic techniques in the early diagnosis of breast cancer when other methods give non-conclusive results. The study includes 160 women with clinical suspicion of breast cancer and non-conclusive findings in mammography, randomized either to scintigraphic scans with Sestamibi Tc 99m or Tl 201. Up to date, 64 women have been enrolled, 46 in Tl-201 and 18 in Sestamibi Tc 99m. Results obtained show 73% sensitivity and 94% specificity with Tl 201 and 77% sensitivity and 100% specificity with Sestamibi Tc 99m. In this group, diagnostic accuracy improves when the tumors are bigger than two centimetres in diameter or when they are palpable. These preliminary results show that scintigraphic breast examinaton seems useful when other diagnostic methods provide non-conclusive results.