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The main purpose of this study was to compare the utility of technetium-99m methoxyisobutylisonitrile (Tc-99m sestamibi) scintimammography with that of ultrasonography for diagnosis of breast cancer in 32 female patients with indeterminate mammographic probability of malignancy because of mammographically dense breast. All breast masses were removed and histopathological diagnosis was obtained in all cases. The results showed 20 of 24 cases of breast carcinoma detected on Tc-99m sestamibi scintimammography. Only one out of eight patients with benign breast lesion had abnormal scintimammographic finding. Ultrasonography diagnosed 22 of the 24 cases of breast carcinoma. However, five out of eight patients with benign breast lesion had positive ultrasonographic findings. In differentiating malignant and benign breast tumors in mammographically dense breast, the diagnostic sensitivities were 83 and 92%, specificities were 88 and 38%, and accuracies were 84 and 78% for Tc-99m sestamibi scintimammography and ultrasonography, respectively. Ultrasonography showed a nonsignificantly higher sensitivity (p0.05), but lower specificity, with more false-positive diagnoses made on ultrasonography. Due to its higher sensitivity, ultrasonography is more suitable for screening breast masses. However, Tc-99m sestamibi scintimammography exhibited significantly higher specificity (p0.05) and accuracy in detecting malignant breast tumors in the current study. We conclude that Tc-99m sestamibi scintimammography is a safe and useful diagnostic method for detection of breast cancer in patients with nondiagnostic mammogram because of mammographically dense breast.

Background High-resolution, high frequency, three-dimensional (3D) breast ultrasound can be used as the first-line, noninvasive imaging tool for the evaluation of patients with breast discharge. Patients and Methods From June 2000 to April 2001, the medical records of 27 consecutive patients with pathologic nipple discharge were evaluated using 3D breast ultrasound equipped with automatic volume scan. Four patients did not undergo surgery because only mild duct dilation, without any visible tumor or vessel structures (around the dilated duct), was found on sonography. Of the remaining 23 patients who subsequently had surgery, four had watery discharge, seven had bloody discharge, five had serous discharge and seven had serosanguineous discharge. Results The final diagnoses were based on determinate histopathology from surgical specimens: intraductal papillary carcinoma (one), intraductal papillomatosis (five), and intraductal papilloma (17). In one of the four patients who did not have surgery, the bloody discharge disappeared 2 months later without recurrence during subsequent follow-up. Conclusions The availability of high-frequency linear transducers now enables us to visualize the mammary duct in detail. The 3D volume images can be reviewed immediately in the bedside ultrasound machine or retrospectively in the computer, so that the relationships between nipple, duct and tumor can be clearly identified. This advantage is one that conventional 2D ultrasound cannot provide.

Background and aim The DNA repair gene Ku70, an important member of non-homologous end-joining repair system, is thought to play an important role in the repairing of DNA double strand breaks. It is known that defects in double strand break repair capacity can lead to irreversible genomic instability. However, the polymorphic variants of Ku70, have never been reported about their association with gastric cancer susceptibility. Methods In this hospital-based case-control study, the associations of Ku70 promoter T-991C (rs5751129), promoter G-57C (rs2267437), promoter A-31G (rs132770), and intron 3 (rs132774) polymorphisms with gastric cancer risk in a Taiwanese population were investigated. In total, 136 patients with gastric cancer and 560 age- and gender-matched healthy controls recruited from the China Medical Hospital in Taiwan were genotyped. Results As for Ku70 promoter T-991C, the ORs after adjusted by age and gender of the people carrying TC and CC genotypes were 2.41 (95% CI = 1.53-3.88) and 3.21 (95% CI = 0.96-9.41) respectively, compared to those carrying TT wild-type genotype. The P for trend was significant (P < 0.0001). In the dominant model (TC plus CC versus TT), the association between Ku70 promoter T-991C polymorphism and the risk for gastric cancer was also significant (adjusted OR = 2.48, 95% CI = 1.74-3.92). When stratified by age and gender, the association was restricted to those at the age of 55 or elder of age (TC vs TT: adjusted OR = 2.52, 95% CI = 1.37-4.68, P = 0.0139) and male (TC vs TT: adjusted OR = 2.58, 95% CI = 1.33-4.47, P = 0.0085). As for the other three polymorphisms, there was no difference between both groups in the distributions of their genotype frequencies. Conclusion In conclusion, the Ku70 promoter T-991C (rs5751129), but not the Ku70 promoter C-57G (rs2267437), promoter A-31G (rs132770) or intron 3 (rs132774), is associated with gastric cancer susceptibility. This polymorphism may be a novel useful marker for gastric carcinogenesis.