Mammography - Scintimammography

A mammogram is an X-ray of the breast on special equipment that can find a breast cancer even when it is too small to be felt. The breast is gently squeezed between two plates to get a good picture. This takes only a few seconds and should not cause pain.

Though a mammogram is not a perfect detection tool, it is the best way to find breast cancer in its earliest stages. The earlier breast cancer is found, the more likely it can be treated successfully. When done by trained professionals on certified equipment, a mammogram is safe.

A screening mammogram will usually find breast cancer before it can be felt. But if you have a lump or notice a change in your breast, you should see your health care provider right away. A diagnostic mammogram may be ordered to find out more.

Link to the source: DMIST

STUDY RESULTS

What were the main results of DMIST?
DMIST showed that, for the entire population of women studied, digital and film mammography had very similar screening accuracy.

Digital mammography was significantly better in screening women who fit any of these three categories:

• Under age 50 (no matter what level of breast tissue density they had)
• Of any age with heterogeneously (very dense) or extremely dense breasts
• Pre- or perimenopausal women of any age (defined as women who had a last menstrual period within 12 months of their mammograms)

There is no apparent benefit of digital over film mammography for women who fit ALL of the following three categories:

• Over age 50
• Those who do not have dense or heterogeneously (very dense) breast tissue
• Those who are not still menstruating

In addition, there was no statistically significant difference in the accuracy of digital mammography compared to film according to digital mammography machine type, race, or breast cancer risk.

Scintimammography may also be referred to as Nuclear mammography, Mammoscintigraphy or Miraluma scan depending on the referring physician. The name derives from the scintilation camera used in nuclear medicine for the majority of nuclear medicine imaging such as bone, brain kidney, lung and thyroid scans. The scintimammogram is a technique developed to improve the specificity for the diagnosis of breast cancer. It originated at Harborside UCLA Medical Center along with other medical centers across the country to aid in evaluating patients with indeterminate physical examination, sonogram and mammography findings. This procedure is also used in patients with dense breasts, with or without a palpable lump and in postoperative patients, when mammograms and sonograms are inconclusive for areas larger than 0.5cm.

There is increasing recognition of the value of the scintimammogram in determining response to chemotherapy and radition therapy. If the scintimammogram does not demonstrate good response, the treatment program is usually changed.

A Mammogram is obtained by using a very low energy x-ray that passes through the breast. This information is recorded on special x-ray film to show anatomical detail. Mammography is well documented for early detection of breast cancer; however it is not as efficient in dense breasts. A Breast Sonogram uses sound waves to show the patterns of the breast. The sonogram is useful in separating nodules shown on mammogram into cysts and some patterns.

Scintimammography uses a radioactive tagged (tracer) material given intravenously that will concentrate in metabolically active cells; for instance cancer cells (if present) to a much greater degree than normal cells. The scintimammogram technique has a high sensitivity for differentiating between scar and cancer as well as other benign conditions and cancer.

As the tracer does not localize in scar tissue, the procedure is beneficial in those patients where there is scar tissue and/or calcification from previous biopsy, lumpectomy, chemotherapy or radiation therapy. There is increasing use of this procedure to monitor response to treatment with chernotherapy and radiation response. The safety of the tracer has been demonstrated by years of use of the same tracer for heart scan.

There is no specific preparation for the Scintimammogram. Make sure you take all your prescribed medications and follow your normal diet.

You should allow approximately one hour to complete your Scintimammogram.

A technologist will escort you to the Nuclear Medicine area where you will be asked to put on a gown. You will receive an injection of the radioactive material into a vein in the foot, if possible. The radiation dose from this procedure is about the same as a chest or abdomen x-ray. The first view is obtained face down with your hands above your head. The scintilation camera will be used to obtain the images of the concentration of the isotope within the breast and adjacent lymph nodes.

Each view takes about ten minutes. When the procedure is complete, the images will be interpreted by the radiologist and the report will be sent to referring physician who will contact you with the results.

As with all procedures of this type, occasionally, the study may require additional views. Consequently, a repeat examination may be required. This does not necessarily suggest malignancy.

The Mammogram and Breast Sonogram are usually the screening procedure for breast disease. The Scintimammogram is an adjunctive procedure to the Mammogram and Sonogram, In patients with an area of abnormality larger than 1/2 centimeter, that cannot be classified as benign or malignant on the Mammogram, Sonogram or physical examination. The Scintimammogram provides additional information in the evaluation as to the need for biopsy of the breast.

Your scan is interpreted by the radiologists and the results are sent to your referring physician. The physicians will have more information to help evaluate breast tissue abnormalities that will assist in the decision whether close follow up or biopsy is necessary. The accuracy of the Scintimammogram has been approximately 90% in differentiation between benign processes and cancer.

If you have any questions, please call (941) 747-3034.