99mTc-MIBI scintigraphy as a functional method for the evaluation of multidrug resistance in breast cancer patients
| Autor: | S B, Sergieva, K V, Timcheva, N D, Hadjiolov |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Technetium Tc 99m Sestamibi Tomography Emission-Computed Single-Photon Carcinoma Ductal Breast Breast Neoplasms Middle Aged Drug Resistance Multiple Neoadjuvant Therapy Radiography Carcinoma Lobular Methotrexate Phenotype Chemotherapy Adjuvant Drug Resistance Neoplasm Antineoplastic Combined Chemotherapy Protocols Humans Female Neoplasm Invasiveness ATP Binding Cassette Transporter Subfamily B Member 1 Fluorouracil Radiopharmaceuticals Cyclophosphamide Aged Epirubicin |
| Zdroj: | Journal of B.U.ON. : official journal of the Balkan Union of Oncology. 11(1) |
| ISSN: | 1107-0625 |
| Popis: | To evaluate the clinical application of (99m) Tc-methoxyisobutylisonitrile (MIBI) scintigraphy as a functional method for assessment of multidrug resistance (MDR) in breast cancer patients and the correlation of these results with P-glycoprotein (P-gp) overexpression and objective response to chemotherapy.22 women, 35-68 years old with breast cancer, suitable for neoadjuvant chemotherapy were included onto this study. Two or three cycles of neoadjuvant chemotherapy were administered (FEC in 15 and CMF in 7 patients). Planar and SPECT (99m) Tc-MIBI scintigraphy was carried out before and after neoadjuvant chemotherapy. Focal (99m) Tc-MIBI uptake in breast cancer lesions was used as a scintigraphic criterion of abnormality. Tumor/background uptake (T/B Index) was calculated. Immunohistochemistry was carried out after surgery for P-gp detection in all cases. The degree of expression was evaluated according to semiquantitative score analysis from 0 to 4.Planar imaging was true positive in 20 patients, false positive in 1 (with breast cancer and mastopathy), and false negative in 1 (with wide tumor necrosis and deep location in the breast). SPECT imaging was true positive in 21 patients and false positive in 1. In 3 patients with multifocal disease additional tumour masses were visualized using SPECT. Sensitivity was 95% (21/22) and 100% (22/22), respectively, for planar and SPECT detection of breast cancer. P-gp expression was positive in 40.8% of the patients and negative in 59.2%. Intense (99m) Tc-MIBI uptake was shown on the planar images in 21 patients independently of the P-gp expression. There was no significant relationship between T/B Index and P-gp detection. Objective response included 2 clinical complete remissions, partial response in 1 patient, minimal response in 12, and no change in 7. Some clinical results corresponded to (99m) Tc-MIBI scintigraphic data: after neoadjuvant chemotherapy T/B Index was reducedor = 20% in 9 patients with objective response.SPECT is an important diagnostic approach for identification of breast cancer with deep location and satellite tumour spots in multifocal disease. T/B Index did not correlate with P-gp overexpression on baseline (99m) Tc-MIBI scan. Objective clinical results after neoadjuvant chemotherapy corresponded to scintigraphic results in 75% of the patients with minimal response. |
| Databáze: | OpenAIRE |
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