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Diagnostic performance of breast-specific gamma imaging in the assessment of residual tumor after neoadjuvant chemotherapy in breast cancer patients

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Abstract

To evaluate the diagnostic performance of breast-specific gamma imaging (BSGI) in the assessment of residual tumor after neoadjuvant chemotherapy (NAC) in breast cancer patients, female breast cancer patients who underwent NAC, preoperative 99mTc-sestamibi BSGI, and subsequent definitive breast surgery were enrolled retrospectively. The accuracy of BSGI in the assessment of residual tumor presence and residual tumor size was evaluated and compared to that of magnetic resonance imaging (MRI) using pathology results as the gold standard. The sensitivity and specificity of BSGI for residual tumor detection in 122 enrolled patients were 74.0 and 72.2 %, respectively, and were comparable to those of MRI (81.7 and 72.2 %; P > 0.100). The residual tumor size was significantly underestimated by BSGI in the luminal subtype (P = 0.008) and by MRI in the luminal (P < 0.001) and HER2 subtypes (P = 0.032), with a significantly lesser degree of underestimation by BSGI than MRI in both subtypes. In the triple-negative subtype, both BSGI and MRI generated accurate tumor size measurements. The residual cellularity of triple-negative tumors was significantly higher than that of the non-triple-negative tumors (P = 0.017). The diagnostic performance of BSGI in the assessment of residual tumor is comparable to that of MRI in breast cancer patients. The assessment of residual tumor extent by BSGI depends on the molecular subtype, but BSGI may be more accurate than MRI. Underestimation of tumor size in the luminal and/or HER2 subtypes by BSGI and MRI may be due to low-residual cellularity.

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Acknowledgments

This study was supported by a grant of the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (HI06C0868).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

Experiments performed in this study comply with the current laws of the Republic of Korea.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea

    Hyo Sang Lee, Jong ** Lee & Dae Hyuk Moon

  2. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Beom Seok Ko, Sei Hyun Ahn, Byung Ho Son, Jong Won Lee, Hee Jeong Kim & Jong Han Yu

  3. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Sung-Bae Kim, Kyung Hae Jung & **-Hee Ahn

  4. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Joo Hee Cha & Hak Hee Kim

  5. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Hee ** Lee, In-Hye Song & Gyungyub Gong

  6. Department of Nuclear Medicine, Ulsan University Hospital, Ulsan, Republic of Korea

    Seol-Hoon Park

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  1. Hyo Sang Lee
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  13. Hee ** Lee
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  17. Jong ** Lee
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  18. Dae Hyuk Moon
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Corresponding author

Correspondence to Dae Hyuk Moon.

Additional information

Hyo Sang Lee and Beom Seok Ko have contributed equally to the work and are co-first authors.

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Lee, H.S., Ko, B.S., Ahn, S.H. et al. Diagnostic performance of breast-specific gamma imaging in the assessment of residual tumor after neoadjuvant chemotherapy in breast cancer patients. Breast Cancer Res Treat 145, 91–100 (2014). https://doi.org/10.1007/s10549-014-2920-z

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  • DOI: https://doi.org/10.1007/s10549-014-2920-z

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