Breast scintigraphy as a prediction of response to neoadjuvant chemotherapy

The objectives of this work are to evaluate the usefulness of radionuclide imaging method breast as predictor of response to neoadjuvant chemotherapy, correlating it with physical examination, mammography and histopathology of the surgical specimen. Introduction: Neoadjuvant chemotherapy (preoperative or primary) is considered an essential part of the multidisciplinary treatment of locally advanced breast cancer. ^99mTechnetium sestamibi enters cells by passive diffusion but through plasma and mitochondrial membranes, a process which is determined by the intensity of local blood flow. This affinity of ^99mTc-MIBI by mitochondria, the large number that are present in these tissues with high metabolic and degree of angiogenesis, (abnormal neoformed vessels percentage) is the basis for application to cancer diagnosis. Patients and methods: We selected 42 patients with palpable nodules greater than 3 cm and mammogram classified as BI-RADS V. The age range spanned from 32 to 64 years, with an average of 50.33 years. All patients were performed tru-cut biopsy of breast lump. And in all of them, the pathology was positive for breast carcinoma. Also give hormone receptors, HER-2/neu and Ki-67. We asked scintigraphy with ^99mTc- sestamibi breast before and after neoadjuvant chemotherapy. Was considered negative in those images where no tracer was setting, capturing images, which showed fixation, those in which the tracer binding manifested faint, and those images showed intense uptake of ^99mTc. Discussion: Breast scintigraphy was not useful in discriminating patients had complete clinical response partial clinical response compared with clinical and mammography, which we were more effective in the diagnosis of residual disease. (authors)