False negative bone scintigraphy in a patient with primary breast cancer: a possible transient phenomenon of bisphosphonate (alendronate) treatment
| Autor: | Emine Osma, Zuhal Başkan, Binnaz Demirkan, Mehmet Alakavuklar, Recep Bekiş, Iknur Bilkay Görken, Emel Ada, Ahmet Alacacioglu |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Cancer Research
medicine.medical_specialty medicine.medical_treatment Osteoporosis Antineoplastic Agents Bone Neoplasms Breast Neoplasms Bone and Bones 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Breast cancer medicine Humans Radionuclide Imaging False Negative Reactions Aged medicine.diagnostic_test Alendronate business.industry Cancer Bone metastasis General Medicine Bisphosphonate medicine.disease Oncology Bone scintigraphy 030220 oncology & carcinogenesis Female False positive rate Radiology business |
| Zdroj: | ResearcherID |
| ISSN: | 0300-8916 |
| Popis: | Breast cancer is the most common cancer and the second leading cause of cancer deaths among women in developed countries. Bone is a frequent site of metastatic disease with a stage-dependent incidence. Most women with breast cancer are at risk of osteoporosis due to their age or their breast cancer treatment. Scintigraphy enables imaging of the entire skeleton with high sensitivity but limited specificity. The false positive rate varies from 1.6% to as high as 22%, while the false negative rate varies from 0.96% to 13%. We observed a 70-year-old woman with a diagnosis of breast cancer and a false negative bone scan despite extensive bone metastases. She was under alendronate treatment for osteoporosis at the time. The false negative finding might be due to a transient phenomenon of alendronate, a bisphosphonate cleared from the plasma by uptake into bone and by renal excretion. 99mTc-MDP is eliminated via the same pathways, and therefore competition may occur between the two substances. Another possible explanation for the false negative bone scan could be that bone metastases, indicating hematogenous tumor spread, are detected earlier by CT scan or MRI than by bone scan. Breast cancer patients under bisphosphonate treatment for osteoporosis must be carefully evaluated for bone metastasis during radionuclide studies with 99mTc-MDP. |
| Databáze: | OpenAIRE |
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