Scintimammography enhances negative predictive value of non-invasive pre-operative assessment of breast lesions

Aims: The aim of this study was to develop a criterion with a high negative predictive value for the evaluation of breast lesions. We aimed to determine the value of combining three non-invasive tests, mammography (MM), ultrasonography (USS) and 99mTc-methoxyisobutylisonitrite (99mTc-MIBI) scintimam...

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Veröffentlicht in:European journal of surgical oncology 2000-12, Vol.26 (8), p.738-741
Hauptverfasser: Mirzaei, S., Zajicek, S.M., Knoll, P., Lipp, C., Lipp, R.W., Salzer, H., Umek, H., Kohn, H.
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container_end_page 741
container_issue 8
container_start_page 738
container_title European journal of surgical oncology
container_volume 26
creator Mirzaei, S.
Zajicek, S.M.
Knoll, P.
Lipp, C.
Lipp, R.W.
Salzer, H.
Umek, H.
Kohn, H.
description Aims: The aim of this study was to develop a criterion with a high negative predictive value for the evaluation of breast lesions. We aimed to determine the value of combining three non-invasive tests, mammography (MM), ultrasonography (USS) and 99mTc-methoxyisobutylisonitrite (99mTc-MIBI) scintimammography (scinti-MM). Methods: We included 94 consecutive patients with suspected lesions detected by mammography or on physical examination. MM, USS and scinti-MM were performed no more than 4 weeks prior to excisional biopsy in all patients. We then compared the biopsy results with a score calculated for each patient, derived from the results of the three tests, which we termed «mamma malignancy index» (MMI). Results: Each of the three exams yielded a score ranging from 0 to 2, with 0 representing an almost certainly benign lesion, 1 an indeterminate finding and 2 a likely malignant lesion, and hence giving a total score ranging from 0 to 6. The biopsy results showed that the lesions in 64 patients were benign. Forty-nine (77%) of these patients had received an MMI score of 0 or 1. The negative predictive value for malignancy in patients with a score less than 2 was 100%.Conclusions: Since the smallest detected lesion was 9 mm in diameter, we conclude that MMI may be a highly useful diagnostic tool in the delineation of breast lesions ≥1 cm which should not be routinely referred for biopsy but may be followed non-invasively. Although fine needle aspiration has limitations, we would recommend it as a less invasive method to evaluate suspected lesions smaller than 1 cm.
doi_str_mv 10.1053/ejso.2000.0995
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We aimed to determine the value of combining three non-invasive tests, mammography (MM), ultrasonography (USS) and 99mTc-methoxyisobutylisonitrite (99mTc-MIBI) scintimammography (scinti-MM). Methods: We included 94 consecutive patients with suspected lesions detected by mammography or on physical examination. MM, USS and scinti-MM were performed no more than 4 weeks prior to excisional biopsy in all patients. We then compared the biopsy results with a score calculated for each patient, derived from the results of the three tests, which we termed «mamma malignancy index» (MMI). Results: Each of the three exams yielded a score ranging from 0 to 2, with 0 representing an almost certainly benign lesion, 1 an indeterminate finding and 2 a likely malignant lesion, and hence giving a total score ranging from 0 to 6. The biopsy results showed that the lesions in 64 patients were benign. Forty-nine (77%) of these patients had received an MMI score of 0 or 1. The negative predictive value for malignancy in patients with a score less than 2 was 100%.Conclusions: Since the smallest detected lesion was 9 mm in diameter, we conclude that MMI may be a highly useful diagnostic tool in the delineation of breast lesions ≥1 cm which should not be routinely referred for biopsy but may be followed non-invasively. Although fine needle aspiration has limitations, we would recommend it as a less invasive method to evaluate suspected lesions smaller than 1 cm.</description><identifier>ISSN: 0748-7983</identifier><identifier>EISSN: 1532-2157</identifier><identifier>DOI: 10.1053/ejso.2000.0995</identifier><identifier>PMID: 11087637</identifier><identifier>CODEN: EJSOE7</identifier><language>eng</language><publisher>Amsterdam: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; biopsy ; Biopsy, Needle ; Breast - pathology ; breast cancer ; Breast Diseases - diagnosis ; Breast Diseases - diagnostic imaging ; Breast Neoplasms - diagnosis ; Diagnosis, Differential ; Female ; Gynecology. Andrology. Obstetrics ; Humans ; Mammary gland diseases ; Mammography ; Medical sciences ; Middle Aged ; Predictive Value of Tests ; Radionuclide Imaging - methods ; scintimammography ; Surgery (general aspects). Transplantations, organ and tissue grafts. 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We aimed to determine the value of combining three non-invasive tests, mammography (MM), ultrasonography (USS) and 99mTc-methoxyisobutylisonitrite (99mTc-MIBI) scintimammography (scinti-MM). Methods: We included 94 consecutive patients with suspected lesions detected by mammography or on physical examination. MM, USS and scinti-MM were performed no more than 4 weeks prior to excisional biopsy in all patients. We then compared the biopsy results with a score calculated for each patient, derived from the results of the three tests, which we termed «mamma malignancy index» (MMI). Results: Each of the three exams yielded a score ranging from 0 to 2, with 0 representing an almost certainly benign lesion, 1 an indeterminate finding and 2 a likely malignant lesion, and hence giving a total score ranging from 0 to 6. The biopsy results showed that the lesions in 64 patients were benign. Forty-nine (77%) of these patients had received an MMI score of 0 or 1. The negative predictive value for malignancy in patients with a score less than 2 was 100%.Conclusions: Since the smallest detected lesion was 9 mm in diameter, we conclude that MMI may be a highly useful diagnostic tool in the delineation of breast lesions ≥1 cm which should not be routinely referred for biopsy but may be followed non-invasively. 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Andrology. Obstetrics</topic><topic>Humans</topic><topic>Mammary gland diseases</topic><topic>Mammography</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Radionuclide Imaging - methods</topic><topic>scintimammography</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. 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We aimed to determine the value of combining three non-invasive tests, mammography (MM), ultrasonography (USS) and 99mTc-methoxyisobutylisonitrite (99mTc-MIBI) scintimammography (scinti-MM). Methods: We included 94 consecutive patients with suspected lesions detected by mammography or on physical examination. MM, USS and scinti-MM were performed no more than 4 weeks prior to excisional biopsy in all patients. We then compared the biopsy results with a score calculated for each patient, derived from the results of the three tests, which we termed «mamma malignancy index» (MMI). Results: Each of the three exams yielded a score ranging from 0 to 2, with 0 representing an almost certainly benign lesion, 1 an indeterminate finding and 2 a likely malignant lesion, and hence giving a total score ranging from 0 to 6. The biopsy results showed that the lesions in 64 patients were benign. Forty-nine (77%) of these patients had received an MMI score of 0 or 1. The negative predictive value for malignancy in patients with a score less than 2 was 100%.Conclusions: Since the smallest detected lesion was 9 mm in diameter, we conclude that MMI may be a highly useful diagnostic tool in the delineation of breast lesions ≥1 cm which should not be routinely referred for biopsy but may be followed non-invasively. Although fine needle aspiration has limitations, we would recommend it as a less invasive method to evaluate suspected lesions smaller than 1 cm.</abstract><cop>Amsterdam</cop><pub>Elsevier Ltd</pub><pmid>11087637</pmid><doi>10.1053/ejso.2000.0995</doi><tpages>4</tpages></addata></record>
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source MEDLINE; ScienceDirect Journals (5 years ago - present)
subjects Adult
Aged
Aged, 80 and over
Biological and medical sciences
biopsy
Biopsy, Needle
Breast - pathology
breast cancer
Breast Diseases - diagnosis
Breast Diseases - diagnostic imaging
Breast Neoplasms - diagnosis
Diagnosis, Differential
Female
Gynecology. Andrology. Obstetrics
Humans
Mammary gland diseases
Mammography
Medical sciences
Middle Aged
Predictive Value of Tests
Radionuclide Imaging - methods
scintimammography
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the genital tract and mammary gland
Technetium
Tumors
Ultrasonography, Mammary
title Scintimammography enhances negative predictive value of non-invasive pre-operative assessment of breast lesions
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