Nuclear medicine imaging of breast cancer

The best hope for improving survival among breast cancer patients is early detection. Standard mammography is the diagnostic tool of choice for the early detection of small breast lesions. Since the introduction of film-screen mammography and new magnification techniques, modern mammography has improved significantly over the last few years. However, approximately 10-15% of all palpable carcinomas cannot be detected on mammography and the treatment outcome may be adversely affected when a biopsy is delayed because of a negative mammography. The main reason for these negative findings is that dense breast tissue, which is most often seen in young women, may obscure tumours. On the other hand, only 15-20% of breast biopsy specimens of non-palpable lesions detected by mammographic screening prove malignent. Thus the specificity of mammography in deciding to perform an excisional biopsy for histological diagnosis is poor. [...] Therefore, a number of new non-invasive imaging techniques are currently employed to improve the sensitivity of diagnosing a malignant or pre-malignant lesion without sacrificing specificity, and to detect axillary lymph node metastases in patients with clinically negative nodes. In this editorial, an overview will be given only of nuclear medicine techniques. Data on their usefulness for tumour detection, treatment evaluation and for choosing a specific treatment will be discussed.