Roentgenographic evaluation of the augmented breast.

We performed a retrospective study to determine the sensitivity of mammography in detecting breast cancer arising in women with augmented breasts. Of eight women with breast implants in whom breast cancer developed, six had mammograms before biopsy. Only two of the six cancers were identified mammographically (sensitivity = 33%), and one of these two was seen only in retrospect. In both cases, the mammographic findings suggested a benign rather than a malignant process. All eight women had a palpable mass and early disease, and all are clinically disease-free at present. The sensitivity of mammography in detecting palpable cancers in a control group of women without implants was 92% (118 of 128). For tumors of 2 cm or less, the sensitivity was 88% (58 of 66). These results suggest that the sensitivity of mammography in detecting breast cancer is decreased when implants are present. Further investigations are needed to determine the effects of prostheses on mammographic evaluations.

Increased extremity uptake on three-phase bone scans caused by peripherally induced ischemia prior to injection.

During arterial flow scintigraphy, increased tracer uptake in the upper extremity has been noted secondary to induced ischemia distal to blood-pressure cuffs and simple tourniquets, employed prior to the injection. We prospectively studied 68 patients undergoing three-phase bone scintigraphy to evaluate the frequency and magnitude of this artifact. The results showed that when a blood-pressure cuff was applied virtually all patients demonstrated increased activity in the extremity of cuff application. When a simple rubber tourniquet was applied few patients demonstrated the artifact. Only one patient, a case of reflex sympathetic dystrophy syndrome, had increased uptake on blood-pool and skeletal-phase images. We recommend that in flow studies of the hands, wrists, and forearms, blood pressure cuffs not be employed and that at least 3 min should elapse between release of the occlusive device and injection. Asymmetry of flow under these conditions is unlikely to be artifact.

Osteoscintigraphy and brachydactylia of the hand.

Few reports have addressed scintigraphic abnormalities in the configuration of the hands. The purpose of this report is to present a case of congenital brachydactylia of the hands and to emphasize both acquired and projectional scintigraphic findings of brachydactylia.