Mammoscintigraphy with 199T1 for breast cancer detection

The purpose of the study was to assess the efficacy of mammoscintigraphy with 199Tl for detection of primary breast cancer and regional disease advance. A total of 120 women were included into the study. Out of them, there were 100 patients with T1-4N0-2M0 breast cancer and 20 patients with benign breast tumors. Sixty-one patients with breast cancer underwent mammoscintigraphy with 99mTc-mIBI (740 mBq). Thirty-nine patients with breast cancer and all patients with benign breast tumors received 199Tl (185 mBq). The E.CAm 180 (Siemens), double-head gamma-camera equipped with parallel, low energy, high resolution collimators for 99mTcmIBI and high energy collimators for 199Tl was used. mammoscintigraphy with 199Tl showed no pathological radiotracer uptake in all patients with benign breast tumors indicating 100% specificity of this diagnostic method. For breast cancer patients, increased radiotracer accumulation in the breast was visualized in 94.8 % patients who underwent 199Tl mammoscintigraphy and in 93.4 patients who received 99mTc- mIBI. For lesions less than 10 mm in size, pathological radiotracer accumulation in the breast was detected in 66 % patients receiving 199Tl (n=6) and in 60 % patients receiving 99mTc-mIBI (n=5). Tumors more than 10 mm in size were visualized in 100 % of cases using both 199Tl and 99mTc-mIBI. For inflammatory breast cancer, tumor nodules were visualized in all cases using both 199Tl and 99mTc- mIBI. multicentric tumor growth was diagnosed in 6 of 9 (66.6 %) patients with 199Tl and in 6 of 13 (46.1 %) patients with 99mTc- mIBI. Thus, sensitivity of mammoscintigraphy with 199Tl for detection of metastatic regional lymph nodes was 60 % and sensitivity of mammoscintigraphy with 99mTc- mIBI was 93.1 %.