Breast-specific gamma imaging in the detection of atypical ductal hyperplasia and lobular neoplasia.

Acad Radiol

Breast Imaging and Interventional Center, Department of Radiology, 2150 Pennsylvania Ave., NW, The George Washington University, Washington, DC 20037, USA.

Published: June 2012

AI Article Synopsis

  • Atypical lesions like atypical ductal hyperplasia (ADH) and lobular neoplasia significantly increase the risk of developing breast cancer and can be detected using breast-specific gamma imaging (BSGI).
  • A study reviewed 1316 BSGI exams and included 15 patients with confirmed ADH or lobular neoplasia, determining the sensitivity of BSGI.
  • Results showed that BSGI had 100% sensitivity in detecting these atypical lesions, indicating its effectiveness in identifying women at increased risk for breast cancer.

Article Abstract

Rationale And Objectives: Atypical lesions such as atypical ductal hyperplasia (ADH) and lobular neoplasia are nonmalignant lesions that are associated with significant increased risk of developing breast cancer. Atypical lesions have been reported to present with focal increased radiotracer uptake on breast-specific gamma imaging (BSGI) examination, a novel physiologic tool for the detection of breast cancer. To date the sensitivity of BSGI in the detection of atypical lesions has not been reported. The purpose of this study is to determine the sensitivity of BSGI in detecting ADH and lobular neoplasia.

Materials And Methods: A total of 1316 patients who received a BSGI exam between January 2006 and July 2009 were retrospectively reviewed. All patients who underwent minimally invasive biopsy and subsequent surgical excision where the highest pathology was solely ADH or lobular neoplasia (reported as ALH, lobular carcinoma in situ or lobular neoplasia), according to the pathology database were included (n = 15). The sensitivity was determined as the percentage of positive BSGI exams out of all patients diagnosed with ADH or lobular neoplasia who received a BSGI.

Results: Patient ages ranged from 39 to 67 (mean, 52). Eight of 15 patients had ADH, 6/15 lobular neoplasia, and 1/15 ADH and lobular neoplasia in one lesion. Fifteen of the 15 (100%) patients with surgically confirmed ADH or lobular neoplasia had a positive BSGI, with focally increased radiotracer uptake at the site of the verified high-risk lesion.

Conclusion: BSGI has a high sensitivity for the detection of atypical, high-risk breast lesions. A diagnosis of an atypical lesion is concordant with focal increased radiotracer uptake with BSGI and can identify women at increased risk for breast cancer.

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http://dx.doi.org/10.1016/j.acra.2012.02.008DOI Listing

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