Differentiation of Benign and Malignant Breast Masses: Comparison of Ultrasonography with Power Doppler Imaging and 99mTc-Scintimammography

Kwon, Jong Won; Moon, Woo Kyung; Lee, Yu Jin; Moon, Min Hoan; Yeo, Jung Seok; Chung, June Key; Noh, Dong Young; Im, Jung Gi

Abstract

PURPOSE: The objective of our study was to compare the value of differential diagnosis of ultrasonography with power Doppler imaging(PDI) and 99mTc-MIBI scintimammography in the evaluation of breast lesions.
MATERIALS AND METHODS
Fifty-five breast lesions in 48 patients underwent both 99mTc-MIBI scintimammography and sonography with PDI. Lesions were classified as benign or malignant on the basis of the absence or presence of a focus of increased activity at scintimammography, and the shape, border, echogenicity and amount of flow at sonography. The accuracy of the two modalities according to tumor size was compared.
RESULTS
Pathologic diagnosis showed that among the 55 lesions, 40 were malignant and 15 were benign. In the detection of breast cancer, sensitivities and specificities were 97.5%(39/40) and 66.7%(10/15) for ultrasonography with PDI and 72.5%(29/40) and 86.7%(13/15) for scintimammography. For 32 lesions smaller than 2 cm, sensitivities and specificities were 94.7%(18/19) and 61.5%(8/13) for ultrasonography with PDI and 57.9%(11/19) and 84.6%(11/13) for scintimammography. For 23 lesions 2 cm or larger, these parameters were 100%(21/21) and 100%(2/2) for ultrasonography with PDI and 85.7%(18/21) and 100%(2/2) for scintimammography.
CONCLUSION
In the diagnosis of breast cancer, ultrasonography with PDI was less specific than 99mTc-MIBI scintimammography. Ultrasonography with PDI was, however, more sensitive than 99mTc-MIBI scintimammography, particularly for lesions smaller than 2 cm.