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A small field of view gamma camera has been developed for integration with a commercial stereotactic core biopsy system. The goal is to develop and implement a dual-modality imaging system utilizing scintimammography and digital radiography to evaluate the reliability of scintimammography in predicting the malignancy of suspected breast lesions from conventional X-ray mammography. The scintimammography gamma camera is a custom-built mini gamma camera with an active area of 5.3 cm × 5.3 cm and is based on a 2 × 2 array of Hamamatsu R7600-C8 position-sensitive photomultiplier tubes. The spatial resolution of the gamma camera at the collimator surface is < 4 mm full-width at half-maximum and a sensitivity of ∼ 4000 Hz/mCi. The system is also capable of acquiring dynamic scintimammographic data to allow for dynamic uptake studies. Sample images of preliminary clinical results are presented to demonstrate the performance of the system.