Role of scintimammography in assessing the response of neoadjuvant chemotherapy in locally advanced breast cancer
Locally advanced breast cancer (LABC) is a common cancer in the developing countries. Neoadjuvant chemotherapy (NACT) is a very important step in the treatment of such tumors and hence that the disease can be down staged and made amenable for surgery. All the tumors do not respond to the therapy equ...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical and Scientific Publishers Pvt. Ltd.
2014-07-01
|
| Series: | World Journal of Nuclear Medicine |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.144816 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850255549413720064 |
|---|---|
| author | Romeeta Trehan Rajeev Seam Manoj Gupta Ashwani Sood Kislay Dimri Rohit Mahajan |
| author_facet | Romeeta Trehan Rajeev Seam Manoj Gupta Ashwani Sood Kislay Dimri Rohit Mahajan |
| author_sort | Romeeta Trehan |
| collection | DOAJ |
| description | Locally advanced breast cancer (LABC) is a common cancer in the developing countries. Neoadjuvant chemotherapy (NACT) is a very important step in the treatment of such tumors and hence that the disease can be down staged and made amenable for surgery. All the tumors do not respond to the therapy equally. Hence, it becomes very important to predict the response of chemotherapy in such cases. This study evaluated the role of scintimammography in assessing the response to NACT in 23 patients with LABC. Histologically proven 23 patients of LABC were recruited in this study. Prechemotherapy tumor size was measured clinically in all patients and technitium (Tc)-99m sestamibi test was performed before NACT for each patient. Early (10 min) and delayed (2 h) image of the breast were acquired in anterior and lateral views after Tc-99m sestamibi intravenous injections and wash out rate (WOR) was computed. After 3-4 cycles of chemotherapy, surgery in the form of modified radical mastectomy was performed in 20 out of 23 patients (3 patients lost to follow-up) with pathologic evaluation of the residual tumor size. The pretherapy Tc-99m sestamibi WOR ranged from 8.3% to 68% with mean ± SD of 34.5% ±16.5%. The prechemotherapy Tc-99m sestamibi study predicted chemoresistance (WOR >45%) in 6 out of 20 patients and no chemoresistance (WOR <45%) in 14 out of 20 patients. When the WOR cut-off was set at >45%, the predictivity of the test was indicated by sensitivity of 91.7%, specificity of 62.5%, positive predictive value of 78.6%, and negative predictive value of 82.3% with a likelihood ratio of 0.1. Tc-99m sestamibi WOR is a reliable test for predicting tumor response to NACT. WOR >45% is highly predictive of chemoresistance with likelihood ratio of 0.1 than WOR <45% being predictive of chemoresponsiveness. |
| format | Article |
| id | doaj-art-421eaf101bb944f5b8092848168f6904 |
| institution | OA Journals |
| issn | 1450-1147 1607-3312 |
| language | English |
| publishDate | 2014-07-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | World Journal of Nuclear Medicine |
| spelling | doaj-art-421eaf101bb944f5b8092848168f69042025-08-20T01:56:52ZengThieme Medical and Scientific Publishers Pvt. Ltd.World Journal of Nuclear Medicine1450-11471607-33122014-07-01130316316910.4103/1450-1147.144816Role of scintimammography in assessing the response of neoadjuvant chemotherapy in locally advanced breast cancerRomeeta Trehan0Rajeev Seam1Manoj Gupta2Ashwani Sood3Kislay Dimri4Rohit Mahajan5Department of Radiotherapy, Government Medical College and Hospital, Chandigarh, IndiaDepartment of Radiotherapy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, IndiaDepartment of Radiotherapy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, IndiaDepartment of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, IndiaDepartment of Radiotherapy, Government Medical College and Hospital, Chandigarh, IndiaDepartment of Radiotherapy, Government Medical College and Hospital, Chandigarh, IndiaLocally advanced breast cancer (LABC) is a common cancer in the developing countries. Neoadjuvant chemotherapy (NACT) is a very important step in the treatment of such tumors and hence that the disease can be down staged and made amenable for surgery. All the tumors do not respond to the therapy equally. Hence, it becomes very important to predict the response of chemotherapy in such cases. This study evaluated the role of scintimammography in assessing the response to NACT in 23 patients with LABC. Histologically proven 23 patients of LABC were recruited in this study. Prechemotherapy tumor size was measured clinically in all patients and technitium (Tc)-99m sestamibi test was performed before NACT for each patient. Early (10 min) and delayed (2 h) image of the breast were acquired in anterior and lateral views after Tc-99m sestamibi intravenous injections and wash out rate (WOR) was computed. After 3-4 cycles of chemotherapy, surgery in the form of modified radical mastectomy was performed in 20 out of 23 patients (3 patients lost to follow-up) with pathologic evaluation of the residual tumor size. The pretherapy Tc-99m sestamibi WOR ranged from 8.3% to 68% with mean ± SD of 34.5% ±16.5%. The prechemotherapy Tc-99m sestamibi study predicted chemoresistance (WOR >45%) in 6 out of 20 patients and no chemoresistance (WOR <45%) in 14 out of 20 patients. When the WOR cut-off was set at >45%, the predictivity of the test was indicated by sensitivity of 91.7%, specificity of 62.5%, positive predictive value of 78.6%, and negative predictive value of 82.3% with a likelihood ratio of 0.1. Tc-99m sestamibi WOR is a reliable test for predicting tumor response to NACT. WOR >45% is highly predictive of chemoresistance with likelihood ratio of 0.1 than WOR <45% being predictive of chemoresponsiveness.http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.144816breast cancerneoadjuvant chemotherapyresponse assessmentscintimammography |
| spellingShingle | Romeeta Trehan Rajeev Seam Manoj Gupta Ashwani Sood Kislay Dimri Rohit Mahajan Role of scintimammography in assessing the response of neoadjuvant chemotherapy in locally advanced breast cancer World Journal of Nuclear Medicine breast cancer neoadjuvant chemotherapy response assessment scintimammography |
| title | Role of scintimammography in assessing the response of neoadjuvant chemotherapy in locally advanced breast cancer |
| title_full | Role of scintimammography in assessing the response of neoadjuvant chemotherapy in locally advanced breast cancer |
| title_fullStr | Role of scintimammography in assessing the response of neoadjuvant chemotherapy in locally advanced breast cancer |
| title_full_unstemmed | Role of scintimammography in assessing the response of neoadjuvant chemotherapy in locally advanced breast cancer |
| title_short | Role of scintimammography in assessing the response of neoadjuvant chemotherapy in locally advanced breast cancer |
| title_sort | role of scintimammography in assessing the response of neoadjuvant chemotherapy in locally advanced breast cancer |
| topic | breast cancer neoadjuvant chemotherapy response assessment scintimammography |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.144816 |
| work_keys_str_mv | AT romeetatrehan roleofscintimammographyinassessingtheresponseofneoadjuvantchemotherapyinlocallyadvancedbreastcancer AT rajeevseam roleofscintimammographyinassessingtheresponseofneoadjuvantchemotherapyinlocallyadvancedbreastcancer AT manojgupta roleofscintimammographyinassessingtheresponseofneoadjuvantchemotherapyinlocallyadvancedbreastcancer AT ashwanisood roleofscintimammographyinassessingtheresponseofneoadjuvantchemotherapyinlocallyadvancedbreastcancer AT kislaydimri roleofscintimammographyinassessingtheresponseofneoadjuvantchemotherapyinlocallyadvancedbreastcancer AT rohitmahajan roleofscintimammographyinassessingtheresponseofneoadjuvantchemotherapyinlocallyadvancedbreastcancer |