ONCOLOGY, Severiche FAA

Abstracts XIX Brazilian Congress of Nuclear Medicine

7. ONCOLOGY

7.2 - BREAST SCINTIGRAPHY WITH [Tc-99m]SESTAMIBI IN THE EVALUATION OF BREAST CARCINOMA RESPONSE TO PRIMARY CHEMOTHERAPY.

Joaquim AI, Severiche FAA, Ramos CD, Etchebehere ECSC, Carvalho DC, Shinzato JY, Vargas RF, Alvarenga M, Camargo EE. Division of Nuclear Medicine, Department of Radiology and Center for Integral Assistance to Woman’s Health (CAISM), Campinas State University (UNICAMP), Campinas, Brazil.

elba@mn-d.com

The precise evaluation of response of locally advanced breast carcinoma to primary chemotherapy is essential in treatment management. Evaluation by mammography and ultrassonography is not always reliable. Breast scintigraphy with [Tc-99m] sestamibi (BS) has been used to evaluate response of chemotherapy in various tumor types, such as sarcomas and brain tumors. The purpose of this study was to investigate the utility of BS in the evaluation of response to primary chemotherapy of locally advanced breast carcinoma. Twenty female patients with mean age 53.8 years were studied. Eleven were T2N0M0 IIA, 7 were T2N1M0 IIB and 2 were T2N2M0 IIIA. Two BS were performed: one prior to and the other 21 days after the third cycle of chemotherapy. Semi-quantitative analysis of tumor uptake before and after chemotherapy was performed. Results were compared with histopathology. The general sensitivity for the detection of breast carcinoma was 95%. The comparison between BS and histopathology in the evaluation of viable tumor after chemotherapy demonstrated an agreement of 75%. BS overestimated viable tumor one grade higher than histopathology in 30% of the concordant cases and in 5% of the discordant cases. Histopathology overestimated tumor viability in 20% of the concordant cases and in 20% of the discordant ones. Tumor viability grading by BS was concordant with histopatological grading in 25% of patients.