According to the American College of Radiology, women over the age of 40 should receive a mammography screening every year. Women under the age of 40 with either a family history of breast cancer or other concerns about their personal breast health should consult their doctor about when to start screenings.
Some mammograms are difficult to interpret due to dense breast tissue, scarring from previous surgery, scattered calcifications, or implants. Further testing is necessary for an accurate evaluation. In most states, patients with dense breasts will receive a notification from their doctor to pursue additional imaging of the breast.
MBI differs from other breast imaging modalities such as mammography and ultrasound in that it is a functional (metabolic) test rather than a structural (anatomic) test. Structural or anatomical imaging takes a picture of the tissue within the breast, both normal and abnormal, like cysts, glands, ducts, tumors or scar tissue. These tests are trying to find something that “looks” suspicious. MBI as a functional imaging procedure images cellular metabolism allowing physicians to see the metabolic activity of the tissue, and see if the tissue “acts” suspicious which can help to differentiate benign from malignant tissue since they often look alike on mammography or ultrasound.
Clinical studies have shown that MBI can detect cancers missed by mammography and ultrasound while leading to fewer benign biopsies than MRI. This seems to be especially true for patients with dense breasts and patients who have types of cancer that are difficult to detect, like lobular carcinoma.
Only moderate pressure is required to help form and stabilize the breast for imaging with MBI, making it much more comfortable than a mammogram. Also, patients are seated comfortably through the entire procedure. Many patients comment that MBI is significantly more comfortable than mammography and MRI.
After the patient is intravenously injected with a small dose of Sestamibi, imaging can begin after 5 minutes and continue as needed for approximately 90 minutes. After about 90 minutes, the washout of Sestamibi may compromise image quality.
The radiopharmaceutical used in the MBI procedure has been used safely for more than 30 years in cardiac stress tests. The majority of the drug leaves your body within hours after administration, and is completely eliminated within 30 hours. For additional information about the pharmaceutical risks of Technetium Tc 99m Sestamibi please visit Cardiolite Website.
MBI involves the injection of a dose to the patient that is comparable with or lower than that of other diagnostic imaging procedures. According to publications, the administered dose is between 8 and 20 mCi.
Costs for the MBI procedure vary depending upon your area of the country, but have been found to range from $300 to $1,000 and in many areas, the total cost of the MBI procedure is less than the 20% co-pay required for many patients undergoing breast MRI.
Mammograms will remain the gold standard in breast cancer screening and will continue to be the standard first step in breast cancer detection. However, MBI, MRI and ultrasound will continue to serve special populations of patients who need tests beyond a mammogram.
MBI is an accurate and non-invasive method for the detection of new malignancies in patients with a history of breast cancer; specifically, because of its ability to differentiate normal scar tissue from cancer. Scar tissue can make finding cancers by mammography or ultrasound difficult but does not affect the sensitivity of MBI.
The Dilon MBI procedure produces a low number of false-positive results (a positive test when no cancer is present). Like all breast imaging studies, MBI will have some false-positives, but the results of clinical studies suggest that MBI has fewer false-positives than other imaging studies.
Many of the benign conditions that cause false-positive MBI results are considered high-risk and are commonly removed by a surgeon. For example, atypical ductal hyperplasia, lobular carcinoma in-situ, and atypical papillomas are often positive by MBI.
Like all imaging studies, MBI will be false negative in some cases, but the results of clinical studies suggest MBI has fewer false negatives than mammography or ultrasound, especially in patients with dense breasts.
The injection used in MBI (Sestamibi) does not contain iodine, but other allergic reactions can exist. For information on potential allergic reactions and after effects of the imaging agent Sestamibi, please visit Cardiolite Website.
Small body movements, such as those listed, do not normally impact breast imaging. However, if your breast slips during the imaging process it will be necessary to restart imaging. Therefore you should make every attempt not to move during the imaging process