The role of nuclear medicine in breast cancer detection: A focus on technetium-99 sestamibi scintimammography

Screening mammography in women aged over 50 years reduces breast cancer death by 30%. However, because mammography cannot accurately differentiate benign from malignant lesions, many mammography-directed breast biopsies are benign. In the past decade, methods of "functional breast imaging," including magnetic resonance imaging, scintimammography using single photon emission tomography, and positron emission tomography, have improved the sensitivity and specificity rates of conventional mammography for the detection of breast cancer. The higher specificity of scintimammography is feeding current enthusiasm for the study of its role in early breast cancer detection, as a complement to mammography in the evaluation of indeterminate lesions, and for use in noninvasive axillary staging. This article reviews the applications of radionuclide technology in breast cancer diagnosis and surveillance.