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Use of a portable gamma camera for guiding surgical treatment in locally advanced breast cancer in a post-neoadjuvant therapy setting.

Abstract
The aim of the present study was to assess the feasibility of a portable gamma camera (PGC) for guiding surgical treatment in locally advanced breast cancer (LABC) after neoadjuvant therapy (NT). Since January 2012, a PGC (Sentinella 102, ONCOVISION) has been available in our center. We planned to perform a feasibility monocentric prospective study involving 15-20 patients with LABC for assessing the diagnostic performance of this PGC after NT (Breast Cancer Surgery-S102). Before the surgical treatment and at the end of NT an injection of 99mTc-Sestamibi (100-150 MBq) was made. Conventional scintimmamography (SMM) and Sentinella 102 images were obtained from 18 patients. 10 (55.5 %) patients showed a focal uptake of tracer in the breast or lymph nodes before or after the surgical excision (on histological specimen), while 8 did not. The histological specimen concluded for a complete response to NT in 4 (22.2 %) patients and for a partial or no response to treatment in the remnant 14 subjects. The specificity and false-negative rate of the Sentinella 102 compared to SMM were 100 % for both and 38 % vs. 60 %, respectively. The global diagnostic accuracy of Sentinella 102 was: 66.7 % (95 % confidence interval: 44.88-88.44 %). The present feasibility study shows how a new nuclear imaging device can be useful in the operating theatre for guiding a radical surgery approach in patients with LABC after NT.
AuthorsLaura Evangelista, Anna Rita Cervino, Riccardo Sanco, Michele Bignotto, Tania Saibene, Silvia Michieletto, Cristina Ghiotto, Fernando Bozza, Marta Paiusco, Giorgio Saladini
JournalBreast cancer research and treatment (Breast Cancer Res Treat) Vol. 146 Issue 2 Pg. 331-40 (Jul 2014) ISSN: 1573-7217 [Electronic] Netherlands
PMID24939059 (Publication Type: Journal Article)
Chemical References
  • Biomarkers, Tumor
  • Technetium Tc 99m Sestamibi
Topics
  • Adult
  • Aged
  • Biomarkers, Tumor
  • Breast Neoplasms (diagnosis, drug therapy, surgery)
  • Chemotherapy, Adjuvant
  • Female
  • Gamma Cameras
  • Humans
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Grading
  • Neoplasm Staging
  • Prospective Studies
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Surgery, Computer-Assisted (methods)
  • Technetium Tc 99m Sestamibi
  • Treatment Outcome

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