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ORIGINAL ARTICLE
Year : 2012  |  Volume : 27  |  Issue : 4  |  Page : 221-225

Role of Tc99m-Sestamibi scintimammography in assessing response to neoadjuvant chemotherapy in patients with locally advanced breast cancer


1 Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Bhagwant Rai Mittal
Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-3919.115391

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Introduction : Neoadjuvant chemotherapy (NACT) is an essential part of multi-disciplinary management of locally advanced breast cancer (LABC). In this study, we aimed at evaluating the role of Tc99m-Sestamibi scinti-mammography in assessing response to NACT in patients with LABC. Materials and Methods: A total of 42 patients of histologically proven LABC were enrolled in this prospective study. Imaging was performed according to pre-defined protocol at 10 min and 4 h after injection of tracer before the start of chemotherapy, 48 h after start of chemotherapy and at the end of chemotherapy. Quantitative parameters were obtained by calculating the ratio of activity in a region of interest (ROI) drawn over the tumor and the same sized ROI drawn in corresponding location in contra lateral breast. Results: At the end of chemotherapy, 6 patients achieved complete response, 25 achieved partial response, 11 had stable disease. Various retention indices calculated at baseline, 48 h after first cycle of NACT, and at the end of chemotherapy showed statistically significant difference in responders and non-responders. By using 84.05 as cut-off point for retention index (RI) of tumor calculated 48 h after first cycle of NACT (RI 2) the positive predictive value and negative predictive value, were found to be 41.9% and 72.7% respectively in differentiating responders from non-responders. Conclusion: Early response assessment in patients with LABC to NACT with Tc99m-Sestamibi scintimammography is feasible and if confirmed by further studies can find routine clinical application in differentiating responders from non-responders.


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