Breast cancer imaging: a new role of Tc-99m sestamibi prone scintimammography for diagnosisof breast cancer

Mammography remians the procedure of choice in screening asymptomatic women for breast cancer. However, in patients with symptoms, other types of imaging play an important role in the detection of malignancies. The high cost and lack of availability of PET and MRI largely precludes the use in this patient population. TI-201 is nbt the imaging agent of choice because of its wash-out and redistribution mechanism in tumor cells; low photon energy also makes the agent less optimal for imaging. Tc-99m sestamibi scintimammography, on the other hand, has high sensitivity and improves the specfficity of conventional mammography forthe detection of breast cancer. In addition, the technique of prone breast imaging is superior to supine imaging bacause of excellent separation of deep breast structures from the myocardium in the left breast, excellent separation of the right breast from the liver and relaxation of the. pectoralis muscle, ultimately improving the resoltion of small deep-seated lesions. For these reasons, Tc-99m sestamibi scintimammography deserves further study as a diagnostic technique to potentially reduce the number of mammographically 'indicated' breast biopsies which yield negative results for cancer.