Ultrasound exams can be augmented by sestamibi nuclear scanning.
The sestamibi breast nuclear study is a test done in radiology centers to help doctors diagnose abnormalities in the breasts. Sestamibi studies are used in combination with physical examinations by physicians, mammograms and ultrasounds to get a complete picture of potential breast disease.
History
Miraluma Tc-99m sestamibi, a dye used in nuclear imaging breast studies, was developed by a group led by I. Khalkhali to evaluate potential breast cancer. Sestamibi is the only agent approved by the U.S. Food and Drug Administration (FDA) for nuclear breast imaging. Since the dye is active on the inside of the breast, it is able to return results that a physical examination, mammography or ultrasound cannot.
Technique
During nuclear imaging, dye is injected intravenously into a vein in the patient at the side of the breast lesion. It is not advisable to inject the dye into the breast without a lesion. If masses are suspected in both breasts, the injection should be done in the dorsum of the patient's foot. The dose of the dye is 25 to 30 mCi (millicuries). After injection, three images of the breast or breasts are obtained.
Process
The dye behaves differently when it encounters cancerous cells than healthy cells. In both cases the dye accumulates in the cells, but at different rates and in different patterns, depending on the particular pathology of the breast. The nuclear imaging process makes it possible for physicians to examine that behavior, learn if cancer is present, and better determine the extent of cancerous cells in the breast.
Benefits
Although sestamibi nuclear breast studies are not used as the primary tool for diagnosing breast cancer, they can be helpful in confirming or ruling out the existence of cancer in certain situations. Patients with extremely dense breast tissue, for example, are difficult to scan with ultrasound and mammography. Surgical and other scars in breast tissue can also make it difficult to find masses in the breast, but sestamibi scanning is not hampered by such structures.
Concerns
Though sestamibi nuclear breast imaging has been widely used since its acceptance by the FDA, some practitioners have expressed concerns about the process. Phillip Shaffer, M.D., explains in a 2002 issue of the Journal of Nuclear Medicine that some patients are referred for sestamibi scanning in order to avoid biopsy. However, Shaffer believes biopsy procedures have improved greatly, is less difficult than previously, and is a minor surgical procedure with minimal discomfort to the patient.
Tags: nuclear breast, nuclear imaging, sestamibi nuclear, breast cancer, breast imaging