Technetium-99m-sestamibi scintimammography to detect breast cancer in patients with paraffinomas or siliconomas after breast augmentation

As the mechanism of (99)mTc-MIBI scintimammography is different from that of anatomic modalities, the detection of breast cancer should not be affected by prior breast augmentation. The aim of this study was to compare the diagnostic accuracy of (99)mTc-MIBI scintimammography for breast cancer in patients with or without paraffinomas or siliconomas. Twenty-eight women with a history of paraffin or silicone injection into the breasts and 17 without were included. All patients received intravenous injection of 1110 MBq (99)mTc-MIBI and were subsequently examined using high-resolution planar and SPECT imaging 5 minutes after the injection. In the 45 patients with 87 breasts, 21 abnormal breasts were found at scintigraphy. The sensitivity, specificity, and accuracy to detect cancer in these breasts with paraffinomas or siliconomas were 100% (5/5), 92% (46/50), and 93% (51/55), respectively. For the breasts without paraffinomas or siliconomas, the sensitivity, specificity, and accuracy were 92% (11/12), 95% (19/20), and 94% (30/32), respectively, not significantly different (p = 0.51, 0.66, and 0.86, respectively). (99)mTc-MIBI scintimammography is both sensitive and specific for the detection of breast cancer, whether or not paraffinomas or siliconomas are present. The accuracy of scintimammography did not seem to be affected by prior breast augmentation.