Molecular Breast Imaging Detects Cancers Missed by Mammography and Ultrasound

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(ChemotherapyAdvisor) – Breast–specific gamma imaging (BSGI) detected malignant or high-risk lesions in patients with negative or indeterminate mammographic results and improved management compared with ultrasound, results of a multicenter clinical patient registry published in the American Journal of Roentgenology have found.

The study, designed to identify patients who might benefit from use of molecular breast imaging techniques such as BSGI, included 1,042 patients, 85% of whom had dense breast tissue. BSGI was recommended when the patient had at least two indications: “equivocal or negative mammogram or sonogram and an unresolved clinical concern; personal history of breast cancer or current cancer diagnosis; palpable masses negative on mammographic and sonographic examination; radiodense breast tissue; or high risk for breast cancer,” the investigators noted.

BSGI had an overall sensitivity of 91% vs. 74% for mammography and 84% for ultrasound. Negative predictive value for BSGI was 96%; specificity, 77%. Results were positive in 408 patients (227 malignant or high-risk lesions requiring additional intervention), negative in 634 (23 with malignant or high-risk lesions), and indeterminate in 69 (all benign lesions).

For patients who had adjunctive imaging procedures with results discordant from those for mammography, BSGI provided higher diagnostic accuracy than ultrasound (77% vs. 35%). BSGI was also more effective than ultrasound in contributing to patient management when the results of these studies changed the diagnosis provided by mammography.

The BSGI procedures, during which patients receive a pharmaceutical tracing agent, were conducted with the Dilon 6800R Gamma Camera, manufactured by Dilon Diagnostics, Newport News, VA.


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