Adjunctive Breast-Specific Gamma Imaging for Detecting Cancer in Women with Calcifications at Mammography
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Mammography detects calcium deposits sensitively, but the specificity for differentiating malignancy from benign calcifications is low. Thus, we investigated whether adjunctive breast-specific gamma imaging (BSGI) has incremental value for detecting cancer in women with suspicious calcifications detected by mammography, and compared BSGI with adjunctive ultrasonography (US).
The medical records of women without a personal history of breast cancer who underwent mammography for breast evaluation from 2009 to 2014 were reviewed retrospectively. Patients who had calcifications detected by mammography, with a result of Breast Imaging Reporting and Data System (BI-RADS) categories 3–5, underwent adjunctive US and BSGI and were included in this study. A total of 302 breast lesions in 266 women (mean age ± standard deviation 49 ± 9 years) were selected for this study.
For detecting breast cancer using mammography plus BSGI, the sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating curve with 95% confidence intervals were 94% (91–96), 90% (86–93), 91% (87–94), 94% (90–96), and 0.92 (0.89–0.95), respectively. For mammography plus US, the respective values were 97% (94–98), 51% (46–57), 68% (63–73), 94% (90–96), and 0.74 (0.70–0.78).
Adjunctive BSGI had higher specificity than adjunctive US without loss of sensitivity. This finding suggests that adjunctive BSGI may be a useful complementary initial imaging method to improve the detection of breast cancer in women who have calcifications with suspicious morphology at mammography.
This paper was supported by Konkuk University. This work has not been previously published and it is not under consideration for publication elsewhere. The publication of this work has been approved by all co-authors.
Hyun Woo Chung, Young So, Jung-Hyun Yang, Kyoung Sik Park, Young Bum Yoo, Nami Choi, Mi Young Kim, Jayoun Kim, and Eun Jeong Lee declare that they have no conflicts of interest.
This study was reviewed by the appropriate Ethics Committee and was therefore performed in accordance with the ethical standards laid down in the Declaration of Helsinki revised in Brazil in 2013. This retrospective study was waived from the need to obtain informed consent by our Institutional Review Board.
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