What is Scintimammography?
Scintimammography (SMM) is a Nuclear Medicine scan that employs a radioactive tracer, Technetium 99m MIBI (also known as Miraluma) to identify abnormal cells based on the difference in metabolic characteristics between cancer cells and non cancerous cells.

How does Scintimammography work?
A small amount of a radioactive tracer is injected into an arm or foot vein, like taking a blood sample. No injection is made in the breast. The tracer then travels throughout the body via the bloodstream. Normal breast tissue takes up very little tracer as against metabolically active cancers which allow them to be easily seen with the help of a special imaging device called a gamma camera. No special preparation is required for the test, and the entire procedure takes approximately 30 minutes to complete.

Is this radioactivity harmful?
The amount of radiation associated with SMM is in the same range as current diagnostic X-rays. Although no amount of radiation, however small, can be proven to be harmless, the fact that we are constantly bathed in a similar range of radiation that comes from our natural environment, indicates that if there is an untoward event, it is so small that it can't be measured.

Why was SMM developed?
The general consensus among experts remains in favour of X-ray mammography as being the screening technique of choice in the early detection of breast cancer.

However, X-ray mammography has its limitations. Mammography looks for an alteration in breast anatomy or the presence of characteristic calcium deposits. In doing so, it uncovers many questionable areas that lead to negative biopsies. In fact, for every cancer discovered via X-ray mammography, four other lesions that are biopsied prove not to be cancer. While this may be great news, the associated stress, anxiety and discomfort as well as the expense to find this out are discomfiting to everyone involved. If a technique were available to help reliably indicate that the lump seen on mammography is in all probability not cancer, it would be a welcome addition in helping to reduce the number of fruitless biopsies. Scintimammography fulfills this criterion, in carefully selected cases.

Another difficulty with mammography is that a number of women, particularly in the younger age groups, have so-called "dense breast tissue" on X-ray which makes detection of a cancer very difficult, if not impossible. Similarly, when there have been silicone implants, a cancer may be obscured on X-ray mammography by the implant. Scintimammography may be helpful in these settings, since it depends not on the tissue density, but the molecular differences between cancer cells and normal cells.

Other special situations which interfere with accurate mammograms and where SMM can be of help include women with scars from breast biopsy or surgery, breast silicone injections, and those with changes from radiation. It is also useful in women with nodular and fibrocystic breast disease, those on hormone replacement therapy, and in cases where there is a strong family history of breast cancer.

How accurate is Scintimammography in detecting breast cancer
Several large studies suggest that SMM is accurate in 90-92% of cases for detection of breast cancer and in 96% of cases for not having the cancer. In a small number of cases, it can detect cancers which cannot be seen on X-ray mammography.

Availability
The Nuclear Medicine Department at Al Zahra Private Hospital, Sharjah, offers SMM on a regular basis. Further information can be obtained from Dr. Shekhar V. Shikare on Tel: 06-5619999 ext. 7061.