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

Yu X, Hu G, Zhang Z, Qiu F, Shao X, Wang X, Zhan H, Chen Y, Deng Y, Huang J - BMC Cancer (2016)

Bottom Line: We investigated the sensitivity and specificity of each method of detection and compared the biological profiles of the four imaging methods.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).

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310009, China.

ABSTRACT

Background: Diagnosing 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.

Methods: During 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.

Results: A 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 %).

Conclusions: BSGI 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.

No MeSH data available.


Related in: MedlinePlus

Images for the case of breast cancer patient with TRN‚ÄČ=‚ÄČ12.75. a MMG for right breast. b US for right breast and axillary. c BSGI image
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Fig5: Images for the case of breast cancer patient with TRN‚ÄČ=‚ÄČ12.75. a MMG for right breast. b US for right breast and axillary. c BSGI image

Mentions: As a functional imaging, semi-quantitative analysis is an important parameter of BSGI, which reflects the Tc-99¬†m MIBI uptake level. We found malignant lesions have a higher TNR than benign lesions (mean 2.61 vs. 1.41, p‚ÄČ<‚ÄČ.0001). This makes the semi-quantitative value of BSGI in breast cancer diagnosis possible. Interestingly, one case had a particularly high TNR, with TNR‚ÄČ=‚ÄČ12.75, and we reviewed this patient‚Äôs medical files. This was a 50-year-old menopausal female, and the imaging examination is shown in Fig.¬†5. The pathologic diagnosis was invasive ductal carcinoma, WHO II grade. IHC tests showed that the tumor was ER negative, PR negative, HER-2 negative, and 30¬†% Ki-67 positive. After biopsy, this patient received standardized therapy and follow-up. At 20¬†months after diagnosis, this patient died because of the rapid spread of cancer with pulmonary metastasis and malignant pleural effusion. This case suggests that a high value of TNR may correlate with a poor prognosis [27].Fig. 5


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

Yu X, Hu G, Zhang Z, Qiu F, Shao X, Wang X, Zhan H, Chen Y, Deng Y, Huang J - BMC Cancer (2016)

Images for the case of breast cancer patient with TRN‚ÄČ=‚ÄČ12.75. a MMG for right breast. b US for right breast and axillary. c BSGI image
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940883&req=5

Fig5: Images for the case of breast cancer patient with TRN‚ÄČ=‚ÄČ12.75. a MMG for right breast. b US for right breast and axillary. c BSGI image
Mentions: As a functional imaging, semi-quantitative analysis is an important parameter of BSGI, which reflects the Tc-99¬†m MIBI uptake level. We found malignant lesions have a higher TNR than benign lesions (mean 2.61 vs. 1.41, p‚ÄČ<‚ÄČ.0001). This makes the semi-quantitative value of BSGI in breast cancer diagnosis possible. Interestingly, one case had a particularly high TNR, with TNR‚ÄČ=‚ÄČ12.75, and we reviewed this patient‚Äôs medical files. This was a 50-year-old menopausal female, and the imaging examination is shown in Fig.¬†5. The pathologic diagnosis was invasive ductal carcinoma, WHO II grade. IHC tests showed that the tumor was ER negative, PR negative, HER-2 negative, and 30¬†% Ki-67 positive. After biopsy, this patient received standardized therapy and follow-up. At 20¬†months after diagnosis, this patient died because of the rapid spread of cancer with pulmonary metastasis and malignant pleural effusion. This case suggests that a high value of TNR may correlate with a poor prognosis [27].Fig. 5

Bottom Line: We investigated the sensitivity and specificity of each method of detection and compared the biological profiles of the four imaging methods.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).

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310009, China.

ABSTRACT

Background: Diagnosing 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.

Methods: During 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.

Results: A 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 %).

Conclusions: BSGI 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.

No MeSH data available.


Related in: MedlinePlus