Nuclear medicine tumorotropic diagnostics in the follow-up and staging of the breast carcinoma

Objective: The review is aimed to present and compare the authors results in the implementation of different tumor imaging radiopharmaceuticals for staging, locoregional biological activity, prognosis, follow-up and side effects in mammary gland cancer. Methods and materials: Groups of patients suspected or with preliminary indications for mammary gland cancer are presented. The patients underwent scintimammography with the following radiopharmaceuticals: 99mTc-MDP, 99mTc-MIBI, 99mTc-tetrofosmin (Myoview), 99mTc-anti CEA, 99mTc-Osteoskan, SPECT gamma camera 18FDG-PET. All scintigraphic results have been verified histologically post-operative and compared with various clinical indicators. For each radiopharmaceutical the specificity, sensitivity and accuracy are presented. Results and conclusions: The application of different radiopharmaceuticals such as 99mTc-tetrofosmin, 99mTc-MIBI, 99mTc-MDP shows higher sensitivity, specificity and accuracy in the initial locoregional diagnostics. The indications are given for scintimammography in hyperdense mammary glands, after surgical interventions for benign fibroadenomas, calcifications, implants etc. for evaluation of the cardiotoxicity of the complex treatment. The scintimammography enables the dynamical assessment of the treatment effect including neoadjuvant chemotherapy and hormone therapy in locally advanced tumors. With the addition of the CARDIO-SPEKT an evaluation of the side effects for the different treatment schemes is possible. 99mTc-MIBI has been used as a criterion for drug resistance. The application of the basic bone scan gives the opportunity of staging with early detection of bone metastases without symptoms. In early scanning the vascularisation rate of the primary tumor is visualized. The application of receptor and immunoscintigraphic nuclear medicine imaging methods visualizes the biological specifics of the tumors. The implementation of the PET with 18FDG gives the opportunity for studying the biological activity of the tumor and its regional and distant metastases, as well as the therapeutic effect giving a new quality to the solving of the breast carcinoma