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Neoadjuvant chemo or hormonotherapy response evaluation in locally advanced primary breast cancer (LAPBC): The role of planar scintimammography (SM) and SPECT

¹ Nuclear Medicine; ² Oncology, University of Sassari, Sassari, Italy

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Objectives: Conventional imaging procedures proved of limited value in assessing tumor response to neoadjuvant chemotherapy in LAPBC.The aim of this study was to evaluate the usefulness of planar scintimammography (SM) in comparison with SPECT in monitoring pre-surgery neoadjuvant chemo or hormonotherapy response in LAPBC patients.

Methods: 99mTc-tetrofosmin conventional planar SM and SPECT were acquired by dual-head gamma camera with HR parallel hole collimators in 38 LAPBC patients before and after neoadjuvant therapy.In 21/38 cases,planar SM with small field of view high resolution dedicated breast camera (DBC) was also acquired.Scintigraphic data were correlated with surgical findings.

Results: At surgery,4/38 patients had pathological complete remission (pCR),while 34/38 patients had residual tumors.Both conventional planar SM and SPECT were true negative in 4/4 (100%) pCR patients,as was DBC in the only studied case. Conventional planar SM and SPECT detected residual tumors in 29/34 (85.3%) and in 31/34 (91.2%) cases, respectively. Both procedures missed 2 multifocal, scattered microscopic residues, only evidenced at DBC. Conventional planar SM also missed 3 further macroscopic residues (15-20 mm), while SPECT only one of these,a mucinous BC,in which DBC was not performed. DBC correctly classified all other 18 patients in whom the procedure was performed.

Conclusions: Both conventional planar SM and SPECT proved useful diagnostic tools in monitoring neoadjuvant chemo/hormono therapy response in LAPBC with SPECT appearing more sensitive; however,our data seem to suggest that sensitivity can further be increased using high resolution DBC, especially in detecting microscopic residual tumor foci.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Spanu, A. Articles by Madeddu, G. PubMed Articles by Spanu, A. Articles by Madeddu, G.