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Michael J. Bernstein
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April 18,1998
New Test Helps Find Cancers in Dense Breasts
Radiologists now have a new diagnostic tool to find cancers in dense breasts, when mammography is not as effective.
The test, called sestamibi scintimammography, is a nuclear medicine procedure which involves the intravenous injection of a radioisotope, which is absorbed by the breast tissue. On the other hand, mammography uses standard x-rays to detect breast cancer. The isotope is sensitive to the cancer in the breast and is not impeded by the denseness of the tissue. Standard mammography has difficulty seeing through the dense tissue.
Dr. Steven L. Edell, a radiologist with the Delaware SPECT Imaging Center and Women's Imaging Center of Delaware, Newark, presented his findings on the test at the 28th National Breast Conference on Breast Cancer, held April 18-21 in Washington, D.C.
The meeting was sponsored by the American College of Radiology.
"Mammography has long been the gold standard as the best method for detecting breast cancer," Dr. Edell says. "Unfortunately, it is limited and less effective in dense, glandular breasts." Women under 50 are most likely to have more dense breasts, he explains.
This new test, which has been approved for use by the Food and Drug Administration, is most useful when a lump is found by the patient or her physician, and mammographic examination results are not conclusive.
The nuclear medicine procedure works best with breast tumors a half inch or larger in diameter, according to Dr. Edell. This is because the resolution, or clarity, is better in a nuclear medicine test when the tumor is larger, he adds.
Dr. Edell says the nuclear medicine breast imaging study can be performed in 35 minutes and the results are available immediately. It contains 1/20 the amount of radiation as a chest x-ray, even less than that of a standard mammogram. He says the test is more costly than mammography or ultrasound, but less expensive than magnetic resonance imaging.
According to Dr. Edell, this nuclear medicine test is not a replacement for screening mammography, but an adjunct. It can't pick up very small breast cancers, so it cannot be used for screening, he adds.
Dr. Edell's experience with more than 600 patients was that sestamibi scintimammography was between 85-90 per cent accurate in finding breast cancer.
"I believe this new test can play a significant role in improving breast cancer diagnosis and reduce the amount of unnecessary breast biopsies,
The American College of Radiology is a major medical association with more 38,000 members worldwide. The membership includes diagnostic radiologists, radiation oncologists and medical physicists.
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