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  • Title: [Scintimammography with 99mTC-MIBI in the clinical practice: repercussion on the clinical management of the patient].
    Author: Prats E, Razola P, Sainz JM, Tardín L, Andrés A, Abós MD, García F, Fernández J, Villavieja L, Banzo J.
    Journal: Rev Esp Med Nucl; 2007; 26(3):153-9. PubMed ID: 17524309.
    Abstract:
    OBJECTIVE: Establish the usefulness of scintimammography (SM) in day-to-day clinical practice. MATERIAL AND METHODS: We have evaluated 308 SM consecutively performed in our Department. The diagnosis was established by way of biopsy or clinical and mammography follow-up (minimum 18 months). In all cases we evaluated the kind of lesions (palpable or non-palpable) and their degree of suspicion of malignancy in the mammography (BIRADS). We determined the number of fine-needle aspiration cytology (FNAC) or biopsies performed in dependence of kind of lesions, mammography and SM results. RESULTS: Final diagnosis was cancer in 18 % of the patients, and 71 % of the lesions were non palpable. Negative predictive value (NPV) of SM was 96 %. Pathological diagnosis was performed in 100 % of lesions with SM+ and 16 % of lesions with SM-. According to the kind of lesion, FNAC and/or biopsy was performed in 62 % of palpable lesions and in 20 % of non-palpable lesions; and according to the mammography in 21 % of lesions BIRADS I-II, 14 % in BIRADS III, 70 % in BIRADS IV and 100 % in BIRADS V. The number of FNAC and/or biopsies performed is significantly higher in all cases when SM is positive (p > 0,001), excepting in BIRADS V lesions. CONCLUSIONS: In day-to-day clinical practice SM is generally performed in low prevalence of breast cancer population, in the evaluation of non-palpable lesions with a low suspicion of malignancy. SM has a high NPV, increase the diagnostic accuracy of the mammography and has repercussion on patient management, except in BIRADS V lesions.
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