Background Information:

What are the other Names for the Procedure?

• Breast Specific Gamma Imaging (BSGI)
• Nuclear Medicine Breast Imaging
• Scintigraphy of Breast

What is Scintimammography radiology procedure? (General Explanation)

• Scintimammography is a type of noninvasive breast imaging assessment that is used to detect cancer cells in the breasts of some women, who have had abnormal mammograms, or who have dense breast tissue. However, it is not used to screen women for breast cancer, or as a replacement to a mammogram
•  The test involves injecting a radioactive substance that emits radioactivity, or a radiotracer into the patient. The radiotracer accumulates differently in various tissues and this helps the doctor determine, whether the tissues are benign or cancerous
• Scintimammography is a nuclear medical technique; it provides information on abnormal tissue activity within the body. This procedure helps in identifying areas suspected of breast cancer, during its early stages

What part of the Body does the Procedure involve?

A Scintimammography procedure involves the human breasts.

Why is the Scintimammography radiology procedure Performed?

• Scintimammography is a follow-up procedure to a traditional mammography, to determine whether a biopsy is needed or not
• In some cases, mammography study is not optimal due to the presence of dense breast tissue. In these cases, Scintimammography is helpful
• This procedure cannot replace a mammography and it is not the primary procedure used in detecting breast cancer
• The images taken by this procedure are not affected by the dense breast tissues or breast implants, unlike with a traditional mammography
• Scintimammography is also used in women with elevated risk of breast cancer and in those who cannot undergo an MRI procedure

What is the Equipment used? (Description of Equipment)

Scintimammography machines use high-resolution gamma cameras that are placed next to the breast, similar to a mammogram. The machine looks very similar to the machines used in mammography.

What are the Recent Advances in the Procedure?

Currently, there are no recent advances to replace the Scintimammography procedure.

What is the Cost of performing the Scintimammography radiology procedure?

The cost of the Scintimammography procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding a Scintimammography procedure and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.radiologyinfo.org/en/info.cfm?pg=scintimammo (accessed on August 3, 2014)

Prior to Scintimammography radiology procedure:

How does the Scintimammography radiology procedure work?

• Scintimammography is performed as an outpatient procedure
• A radiotracer is injected into the patient’s body and accumulates in the organ being examined
• This accumulation of the radiotracer, gives-off gamma rays, which are then detected by the gamma cameras
• A computer connected to the gamma camera produces the images
• The radiotracer injected into the body accumulates in greater quantity in areas, where there are more metabolic or chemical activities, thus producing high-intensity gamma rays. These areas are called “hot spots”
• The radiotracer accumulates in areas of low chemical activities, giving-off low-intensity gamma rays; these areas are called “cold spots”
• The Scintimammography procedure provides information about the physiological tissue activity that take place in the body, instead of information on body anatomy or structure
• “Hot spots” or areas of greatest intensity and require further evaluation, as determined by a radiologist

How is the Procedure Scintimammography radiology procedure Performed?

• Before the Scintimammography imaging is taken, the patient is injected with radiotracers
• The breast is compressed with a plate and placed near the gamma camera
• Images are then taken, which are interpreted by a radiologist

Where is the Procedure Performed?

A Scintimammography procedure is performed as an outpatient procedure, at the hospital.

Who Performs the Procedure?

A radiologist or a physician with nuclear medicine training, performs from the Scintimammography procedure.

How long will the Procedure take?

A Scintimammography procedure takes anywhere between 45-60 minutes to perform.

Who interprets the Result?

• The radiologist interprets the results from a Scintimammography and informs the primary care physician, who then informs the patient
• The patient may be asked for follow-up exam, if there is a suspicious finding that needs to be investigated further

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to a Scintimammography procedure:

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
• Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
• Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
• It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the X-ray
• Women should notify the physician, if they are pregnant or breastfeeding their child; as many such procedures may not be performed on pregnant women
• The patient must avoid eating or drinking at least 8 hours prior to the procedure, depending on when the procedure is arranged
• Depending on the procedure adopted, the patient may be asked for certain bowel or bladder preparations, before the preparation sessions

What is the Consent Process before the Procedure?

A physician will request your consent for a Scintimammography procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the Scintimammography procedure:

• This procedure helps determine, whether or not the patient needs a biopsy. Thus, it helps avoid the need for unnecessary invasive procedures, such as a biopsy
• The images taken by Scintimammography procedure is not affected by any dense breast tissue or breast implants, unlike with a traditional mammography

Following are the risks of the Scintimammography procedure:

• The radiation dose used by injecting a radiotracer is very low and it causes no potential problems
• Other procedures, such as an ultrasound, mammography, or an MRI scan, uses lower radiation doses than the Scintimammography procedure. However, it is a good option, if the patient cannot undergo any of these procedures
• There is a very slight chance of an allergic reaction, due to the injected radiotracer
• A physician should be informed if the patient is pregnant, since this procedure can affect the growing fetus 

What are the Limitations of the Scintimammography radiology procedure?

Following are limitations of the Scintimammography procedure:

• The procedure can neither be used as a primary screening procedure for breast cancer, nor can it be used as a replacement for mammography
• It is not a very accurate tool in detecting abnormalities smaller than one centimeter (in dimension)
• Functional information achieved from the Scintimammography procedure cannot be obtained from any other procedure; but, image resolutions of structures of the body may not be as clear as other procedures, such as with an MRI scan or mammography
• A Scintimammography procedure is generally time-consuming

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is the Scintimammography procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place, during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• What are the costs involved?

During the Scintimammography radiology procedure:

What is to be expected during the Scintimammography radiology procedure?

• A Scintimammography procedure is painless; however, the patient may experience a slight pin-prick, when the radiotracer is injected
• The patient may experience a slight metallic taste in their mouth, after the radiotracer is injected
• The individual will feel pressure on their breast, as the breast is compressed on the device platform to take the images
• There may be some discomfort, as the patient may need to remain still throughout the procedure

What kind of Anesthesia is given, during the Procedure?

The patient is administered either general or local anesthesia, for the Scintimammography procedure.

How much Blood will you lose, during the Procedure?

There is no blood loss involved, during a Scintimammography procedure.

What are the possible Risks and Complications during the Scintimammography radiology procedure?

The possible risks of Scintimammography procedure include:

• Diagnostic procedures, such as ultrasound, mammography, or MRI, use lesser radiation dose than a Scintimammography procedure. Nevertheless, Scintimammography is a good option, if the patient is unable to undergo any of these procedures
• There is a very slight chance of allergic reaction, due to the radiotracer. Although, the radiation dose injected into the body by the radiotracer is very low, and generally causes no problems
• A physician should be informed, if the patient is pregnant. The procedure can affect the growing fetus

What Post-Operative Care is needed at the Healthcare Facility after the Scintimammography radiology procedure?

• Generally, there is no postoperative care required at the healthcare facility, after a Scintimammography procedure
• However, if the patient experiences an allergic reaction to the anesthesia or radiotracer, then they should immediately notify the physician

After the Scintimammography radiology procedure:

What is to be expected after the Scintimammography radiology procedure?

• Generally, no complications or side effects are observed after the Scintimammography procedure
• The patient may resume their normal activities immediately after the procedure, unless instructed otherwise by their healthcare provider

When do you need to call your Physician?

• If the patient experiences an allergic reaction to the anesthesia, then he or she should notify the physician immediately
• Also, if there is redness or swelling, a week after the Scintimammography procedure, the patient should contact their healthcare provider

What Post-Operative Care is needed at Home after the Scintimammography radiology procedure?

• No specific post-operative care is needed at home, after the procedure
• The patient may resume their normal activities after the Scintimammography procedure

How long does it normally take to fully recover, from the Procedure?

The patient should recover fully within 24 hours and be able to resume their normal/routine activities, after the Scintimammography procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

No tissue is extracted from the patient during a Scintimammography procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Scintimammography radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers. 

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• A radiologist, performing the procedure
• Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Scintimammography procedure is performed.