What is it about?

This article provides guidelines for performing and interpreting breast scintigraphy, a nuclear medicine imaging test, to detect breast cancer. Key points: * Breast scintigraphy involves injecting a radioactive tracer into the patient and then imaging the breasts with a specialized gamma camera to see how the tracer distributes in the breast tissue. * It is often used in patients with signs/symptoms of breast cancer or an abnormal mammogram to help characterize suspicious lesions and detect multicentric disease. * The guidelines cover patient preparation, radiotracer dose, imaging protocols, interpretation criteria, documentation, and quality control. * Radiation dose estimates are provided. Breast scintigraphy delivers lower radiation doses than PET/CT or SPECT/CT scans. * Advantages of breast scintigraphy over MRI include lower cost, wider availability, and the ability to image patients who can't have MRI due to implants, claustrophobia, etc. These guidelines standardize nuclear medicine breast cancer imaging protocols to improve diagnostic accuracy and appropriate use.

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Why is it important?

Here are some reasons why these breast scintigraphy guidelines are important: * Standardize imaging protocols and interpretation criteria to optimize diagnostic accuracy. This helps ensure breast cancers are detected and avoids false positives. * Guide appropriate use of breast scintigraphy based on evidence for clinical utility in specific indications. Avoid over- or under-utilization. * Improve quality control and radiation safety practices for breast scintigraphy procedures. * Provide a reference for nuclear medicine practitioners to implement this technique effectively. * Allow comparisons of multi-center research studies using consistent protocols. * Present an alternative imaging option for patients who can't have breast MRI or have dense breast tissue limiting mammogram accuracy. * Optimize presurgical planning and neoadjuvant chemotherapy monitoring with a breast-specific and targeted nuclear imaging technique. In summary, the guidelines will promote the safe, effective use of breast scintigraphy to improve breast cancer detection and diagnosis. This impacts patient care and outcomes.

Perspectives

These guidelines represent an important advance for the field of nuclear medicine and for patients who may benefit from breast scintigraphy. Our group of experts aimed to establish consensus protocols and interpretation criteria to standardize this technique across institutions. This helps ensure its appropriate and effective use for detecting breast cancer, particularly in cases where mammography has limitations. Breast scintigraphy has unique advantages over anatomical imaging modalities due to its ability to assess radiotracer uptake in malignant lesions. We can achieve excellent resolution and target cancer foci with specialized gamma cameras optimized for the breast. These guidelines synthesize evidence from many studies demonstrating the utility of breast scintigraphy in specific clinical indications. This will promote its role in multimodality breast imaging when findings are indeterminate or suspicious. As a clinician, I'm excited to have these standardized guidelines help provide optimal care for patients who may benefit from scintigraphy, including staging, monitoring therapy, and presurgical planning. These SNM guidelines represent a major milestone for advancing breast scintigraphy in clinical practice. They will help us realize the full potential of this technology to impact early breast cancer detection and precision diagnosis.

Thomas F Heston MD
University of Washington

Read the Original

This page is a summary of: SNM Practice Guideline for Breast Scintigraphy with Breast-Specific  -Cameras 1.0, Journal of Nuclear Medicine Technology, November 2010, Society of Nuclear Medicine,
DOI: 10.2967/jnmt.110.082271.
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