Clinical importance of (99m)Tc-MIBI mammoscintigraphy in multifocal breast lesions.

Background: This paper describes the case of a 57-year- -old woman. During self examination the patient discovered a palpable lesion in the left breast. Mammography and USG revealed a single lesion with suspicion of proliferative aetiology. The consulting surgeon stated two palpable lesions in the left breast. Divergence of standard imaging modalities (RTG, USG) and palpation results convinced the surgeon to qualify the patient for mammoscintigraphy.

Material And Methods: Examination was carried out with a single-headed gamma camera Nucline TH (Mediso, Hungary). The patient was given 740 MBq (99m)Tc-MIBI intravenously. Acquisition began ten minutes after radiotracer administration. The patient was in prone position, and the head of the camera was positioned in a lateral view. Data acquisition for a single view lasted 15 minutes. Examination, according to the same protocol, was repeated after surgical treatment.

Results: The scintigraphic image showed two foci of pathologically increased radiotracer uptake in the left breast raising serious suspicion of multifocal breast cancer. Following present guidelines the authors desisted from mammotomic biopsy and the patient underwent Pateys mode mastectomy. Histological examination of the material confirmed preliminary diagnosis. Control images obtained over the three months after surgery revealed homogenous tracer disposition within the remaining tissue.

Conclusions: 1. Mammoscintigraphy is a sensitive and specific method of visualizing palpable lesions. 2. Mammoscintigraphy seems to be a valuable and potentially decision-influencing method of evaluation of palpable lesions, when commonly used tests give divergent results. 3. Use of mammoscintigraphy in diagnostic protocol allows the lowering of the number of unnecessary biopsies, which reduces the risk of possible complications and improves the cost effectiveness of the diagnostic procedure.