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Primary breast cancer imaging with technetium-99m sestamibi and its relation with P-glycoprotein overexpression

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Abstract

The aim of this preliminary study was to evaluate retrospectively sestamibi scintigraphy in relation to the presence of the 170-kDa P-glycoprotein (Pgp), which represents an expression of multidrug resistance in patients with primary breast cancer. Fifteen women (age range 37–76 years) were referred for technetium-99m sestamibi scintigraphy because of suspicious breast lesions detected by mammography and ultrasonography, and subsequently assessed by fine-needle aspiration. Scintigraphy was performed 30 min following the injection of 500 MBq99mTc-sestamibi. Three planar anterior and oblique images were obtained with the patient in the supine position. Excised tumours were assessed for cytosolic CA 15.3, oestrogen (OR) and progesterone (PR) receptors and c-erb B2neu oncogene. Pathology revealed that only 13 of the 15 patients had malignant tumours. The two benign tumours were sestamibi-negative and Pgp-positive. Sestamibi scintigraphy was positive in 10 of the 13 malignant lesions (including nine of ten infiltrating ductal carcinomas). Two of the three lesions with false-negative scintigraphy were Pgp-negative; in one of these cases histology revealed an invasive lobular carcinoma and in the other, mucinous adenocarcinoma. The third false-negative lesion was a Pgp-positive infiltrating ductal carcinoma which was c-erb B2neu-negative but CA 15.3-, OR- and PR-positive. This preliminary study confirms that the resistance to chemotherapy which may occur in patients with primary breast cancer can be a cause of negative sestamibi scintigraphy.

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Authors and Affiliations

  1. Médicine Nucléaire, CHU Bobigny, Paris, France

    Jean-Luc Moretti

  2. Médicine Nucléaire Oncologie, Hôpital P Zobda Quitman, Fort de France, France

    Hervé Azaloux & Dominique Boisseron

  3. Service de Biochimie, Hôpital Henri Mondor, Créteil, France

    Jean-Claude Kouyoumdjian

  4. Service de Cancérologie-Radiothérapie, Institut Curie, Paris, France

    Jacques Vilcog

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  1. Jean-Luc Moretti
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  2. Hervé Azaloux
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  4. Jean-Claude Kouyoumdjian
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  5. Jacques Vilcog
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Moretti, JL., Azaloux, H., Boisseron, D. et al. Primary breast cancer imaging with technetium-99m sestamibi and its relation with P-glycoprotein overexpression. Eur J Nucl Med 23, 980–986 (1996). https://doi.org/10.1007/BF01084375

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  • DOI: https://doi.org/10.1007/BF01084375

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