Date of Graduation

Winter 1-2011

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Dr. Torry Cobb

Abstract

Background: As the second most diagnosed cancer among women in the US, breast cancer has been, and continues to be, a life threatening disease affecting thousands. Mammography has been the primary tool used in screening for breast cancer for decades, despite minimal advancement in the area of its main limitation, dense breast tissue. Recently gamma imaging has undergone significant improvements in the area of breast specific imaging and appears primed to address the needs of a population where mammography is insufficient. The purpose of this systematic review is to compare the efficacy of Breast Specific Gamma Imaging (BSGI) and mammography as a screening tool in detecting breast cancer, using GRADE criteria to evaluate the evidence and the strength of the recommendations made.

Method: An extensive search of available medical literature was conducted using variations of the keywords: Breast Cancer, Gamma Imaging and Mammography. Three observational articles were used for this systematic review.

Results: A large study of 936 participants with BI-RADS rated dense breast tissue where mammography and Breast Specific Gamma Imaging (BSGI) were compared for screening sensitivity and specificity. Two smaller studies evaluated BSGI’s ability to find occult foci after positive screening on mammography. Overall BSGI demonstrated superior sensitivity and specificity over mammography in all three studies.

Conclusion: Based on the results BSGI is recommend as adjunct imaging. The articles used were evaluated using GRADE and were found to be of moderate level of evidence, with the recommendations contingent upon further research.

Keywords: Breast Cancer, Dense Breast Tissue, Gamma Imaging.

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