Breast Cancer Clinical Trial
Official title:
Evaluation of Low-dose Molecular Breast Imaging as a Screening Tool in Women With Mammographically Dense Breasts and Increased Risk of Breast Cancer
A new test for breast cancer screening, molecular breast imaging (MBI) may be more sensitive
than mammography for detecting breast cancer in women with dense breasts. The purpose of
this study is to see if MBI using a low dose of gamma radiation can find cancers not seen on
mammography.
Hypotheses: 1. Low-Dose MBI has a significantly higher sensitivity and specificity and equal
or higher positive predictive value than SM in women age 40 and older with mammographically
dense breasts. 2. Low-dose MBI has comparable sensitivity and specificity to that previously
achieved with MBI using a higher dose of radiation. 3. MBI produces a low false positive
rate (specificity >90%) that permits its use as a screening tool in this patient population.
A previous study demonstrated that the addition of MBI using 20 mCi Tc-99m sestamibi to
screening mammography (SM) increased diagnostic yield for breast cancer in dense breasts
(supplemental yield of 7.5/1000 screened). After implementing radiation dose reduction
techniques, the performance of incident SM and prevalent screen MBI in women with dense
breasts will be compared.
Methods:
Women presenting for SM with heterogeneously or extremely dense breasts on past prior SM
were enrolled and underwent digital SM and MBI. Study information was sent to all eligible
patients in advance of their scheduled SM explaining the study and offering them
participation. Eligible patients who requested to participate were offered an MBI on the
same day as their SM or within 21 days of the SM. Participants may have participated in this
screening study up to two times provided at least 24 months had elapsed since the initial
MBI scan. This time period was selected as the average time for a tumor to double in size is
approximately 20 months. Hence a 24 month time interval between MBI studies was to enable
detection of interval cancers or cancers that were too small to be detected in the initial
MBI scan.
MBI was performed with 8 mCi Tc-99m sestamibi and dual-head cadmium zinc telluride
detectors. SMs were read independently; MBIs were read in comparison with SM. MBIs were
assigned an assessment score of 1-5 which parallels BI-RADS; scores of 3-5 on MBI were
considered positive.
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Intervention Model: Single Group Assignment, Masking: Single Blind (Investigator), Primary Purpose: Diagnostic
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