Rachel Frydman Brem MD, Presenter: Board of Directors, iCAD, Inc Board of Directors, Dilon Technologies LLC Board member, Dilon Technologies LLC Stock options, iCAD, Inc Stockholder, Dilon Technologies LLC Consultant, Siemens AG Consultant, U-Systems, Inc Consultant, Dilon Technologies LLC Consultant, Koninklijke Philips Electronics NV

Caitrin M Coffey BS, Abstract Co-Author: Nothing to Disclose

Jocelyn A. Rapelyea MD, Abstract Co-Author: Nothing to Disclose

Jessica Torrente MD, Abstract Co-Author: Nothing to Disclose

Jennifer H Lieberman BA, Abstract Co-Author: Nothing to Disclose

Megan R Kann BA, Abstract Co-Author: Nothing to Disclose

Anita McSwain MD, MPH, Abstract Co-Author: Nothing to Disclose

Christine Teal, Abstract Co-Author: Nothing to Disclose

The sensitivity of mammography for women with dense breasts is limited and necessitates adjunct imaging modalities not impacted by breast density. Breast-specific gamma imaging (BSGI), which relies on the metabolic and physiologic differences between breast cancer and normal tissue, is effective in breast cancer detection with a reported sensitivity of 94-98%. Studies demonstrate that the precursor to BSGI, nuclear medicine imaging of the breast using a traditional gamma camera, was equally effective for dense and non-dense breasts yet limited in its ability to detect sub-centimeter cancers. BSGI with a high resolution, breast-specific gamma camera was developed to reliably detect cancers as small as 1mm. To date, the sensitivity of BSGI for women with dense and non-dense breasts has not been quantitatively compared. The purpose of this study is to evaluate the sensitivity of BSGI for the detection of cancer in dense versus non-dense breasts.

A retrospective review of the BSGI database from January, 2004 to August, 2009 identified 344 women diagnosed with breast cancer who concurrently underwent BSGI, and for whom breast density was available per mammography report. Patients with breasts described as “fatty replaced” (BIRADS 1) or “scattered fibroglandular tissue” (BIRADS 2) were classified as non-dense while those described as “heterogeneously dense” (BIRADS 3) or “extremely dense” (BIRADS 4) were classified as dense. BSGI examinations exhibiting focally increased radiotracer uptake in the area of biopsy-proven cancer were considered positive according to BSGI reports in the medical record.

The overall sensitivity of BSGI for breast cancer detection was 95.6%. 137 of 142 (96.5%) women with non-dense breasts and 192 of 202 (95.1%) women with dense breasts had positive BSGI examinations. There is no difference in the sensitivity of BSGI in women with non-dense and dense breasts (p = 0.511).

The sensitivity of BSGI is not affected by breast density. BSGI is a useful adjunct imaging modality for the detection of breast cancer in women with all breast densities.

Breast-specific gamma imaging is equally effective for breast cancer detection in women with dense and non-dense breasts.

Brem, R, Coffey, C, Rapelyea, J, Torrente, J, Lieberman, J, Kann, M, McSwain, A, Teal, C, Breast-specific Gamma Imaging for the Detection of Breast Cancer in Dense vs Nondense Breasts.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11003944.html