Oncology 73, ABSTRACTS XVI ALASBIMN CONGRESS. NUCLEAR MEDICINE 1999.

ABSTRACTS XVI ALASBIMN CONGRESS NUCLEAR MEDICINE 1999.

3. ONCOLOGY

A Al Yasi, H Jan, M Granowska, M J Carroll, D Ellison, S J Mather, C Wells+, R Carpenter*, K E Britton. Departament of Nuclear Medicine, Breast Surgery* and Pathology+, Imperial Cancer Research Fund (ICRF), Nuclear Medicine group, St. Bartholomew's Hospital, London.

THE USE OF 99M-TC LABELLED HUMANISED ANTI-HUMAN MILK FAT GLOBULE (HHMFG) MONOCLONAL ANTIBODY FOR THE IDENTIFICATION OF LYMPHATIC SPREAD OF BREAST CANCER.

Objective: To evaluate prospectively. Axillary lymph nodes as to the presence of malignant involvement or not prior to breast cancer surgery, particularly when clinically impalpable.

Methods: 500 MBq of 99m-Tc hHMFG (genetically engineered by the ICRF) was injected IV with anterior chest images at 10 minutes, 3h and 24 hours. Six Barium-133 markers were used for image repositioning. Analysis with change detection algorithm provided colour coded probability maps for locating sites of significant difference between the 10 minutes and later images. Imaging in 15 patients with primary breast cancer was compared with histology.

Results: Imaging gave 8 true positives, 6 true negatives and one "false" positive (second tumour not node3, sensitivity= 100%, negative predictive value= 100%, Specificity= 86% and accuracy= 93%, although numbers are small. These may be compared with our previous experience with 99m-Tc SM3 (29 studies ) with this analysis: sensitivity = 90%, negative predictive value= 94% and specificity= 84%.

Conclusion: in the first clinical use of this humanised antibody in breast cancer 99m-Tc hHMFG appears to be at least as effective as 99m-Tc SM3. These techniques should allow the extent of surgery to be tailored to the individual wornan, and allow explanation of the extent of the proposed surgery.

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