Breast scintigraphy (mammoscintigraphy) is a highly sensitive method of diagnosing tumor formations by assessing the distribution of radioisotope pharmaceuticals in breast tissues. Tumor cells have an increased tropicity to radiopharmaceuticals, accumulating them, which makes it possible to identify primary foci of malignant tumors at the non-palpable stage, detect metastatically affected lymph nodes, predict tumor sensitivity to radiation and chemotherapy, diagnose tumor relapses, etc. The study is carried out using a digital gamma camera by registering an image after intravenous administration of a radiopharmaceutical.
The referral for scintigraphy is given to the patient by the attending physician, in the case when a clinical examination, laboratory tests do not allow to establish a complete picture of the disease.
The procedure is recommended for women in the following situations:
- suspicion of the formation of a primary malignant tumor;
- uncertain mammography results (for example, if questionable microcalcinates are detected);
- the presence of scars left after surgery on the gland or biopsy;
- the need to detect metastasis to lymph nodes;
- x-ray density of breast tissues;
- suspected relapse of the disease;
- multicentric, synchronous cancer;
- fibrocystic mastopathy.
The imaging method is used in the differential diagnosis of both palpable and non-palpable formations in the glands. The study allows us to predict the potential response of pathologically altered cells to drugs, to evaluate the effectiveness of radiation or chemotherapy.
Standard protocols recommend scintigraphy from the 5th to the 10th day of the menstrual cycle. However, a reliable relationship between this factor and the results of the study has not been established. Ladies in the postmenopausal period are allowed to be examined at any time.
In some cases, scintigraphy will have to be postponed:
- after surgery — for 2 months;
- if a fine needle puncture biopsy was performed – for 14 days;
- after a pistol biopsy – for 4-6 weeks.
The procedure does not require complex special training. Two weeks before it is necessary to pass a biochemical blood test. Four hours before the manipulation, you should stop eating. Going to the clinic, you need to wear clothes in which it will be convenient to inject into the leg.
The doctor injects a radioisotope (99mTc-Technetril) into the vein. The patient goes to the waiting room, where she spends from 15 minutes to 3 hours (when analyzing the presence of bone metastases).
After the injection, the patient, for some time, is a source of ionizing radiation. During the waiting period, it is necessary to exclude contact with other people, especially young children and pregnant women.
Then the woman lies down in a tomographic gamma camera, where she is photographed in several projections:
- straight — lying on your back with your hands behind your head;
- two lateral — in the position on the stomach. The arms are stretched forward, the detector from the side approaches as close as possible to the area under study;
- oblique – it is required only if it is necessary to clarify the localization of the neoplasm.
On the tomograph table, you need to be in a state of complete rest, breathe steadily. Any movement distorts the image. All metal items of clothing and jewelry must be removed in advance.
The patient stays in the gamma chamber from 20 minutes to an hour. Then the girl is given the scan results in her hands, she can go home. The complete examination takes 1.5-2 hours.
Interpretation of results
The results of breast scintigraphy are displayed on the screen of one or more gamma cameras in the form of digital data (scintigrams). They contain information about the presence of a radiopharmaceutical in breast tissues, the lymphatic system:
- 99mTc-Technetril is not observed in a clinically healthy gland;
- fibrocystic mastopathy is characterized by a rather intense diffuse accumulation of a radioisotope, without a clear localization;
- in case of a tumor lesion, a focal inclusion of 99mTc-Technetril is visualized, which is significantly higher in intensity than the surrounding background (the so-called “hot node”).
The study has a high specificity (about 93.5%), regardless of the size of the node of the primary neoplasm. It allows you to accurately determine the location of the tumor, its type, and detect metastasis to the lymph nodes.
Breast scintigraphy is a relatively safe diagnostic method. In most cases, the procedure is painless, well perceived by the body.
Some women may have side effects such as:
- increase in blood pressure;
- uncomfortable sensations in the back or neck area.
- Such manifestations belong to the variants of the norm, pass independently within a few hours, do not require special treatment.
Breast scintigraphy should not be performed for pregnant, nursing mothers, as well as patients whose weight exceeds 120 kg.
Contraindications to manipulation are any severe conditions of the patient that prevent him from being placed in a tomograph, maintaining immobility during scanning.
Scintigraphy is a safe procedure with high diagnostic value. It helps to identify foci of malignant cells long before the first symptoms of the disease appear. Some women refuse to be examined for fear of radiation exposure. You can’t do that. Without a full-fledged examination, it is impossible to choose the optimal therapeutic course, to stop the growth of the tumor. Modern gamma tomographs do not harm humans. The radiopharmaceutical is quickly, painlessly removed from the body without causing damage.