Timing and potential role of diagnostic I-123 scintigraphy in assessing radioiodine breast uptake before ablation in postpartum women with thyroid cancer: a case series

Clin Nucl Med. 2006 Nov;31(11):683-7. doi: 10.1097/01.rlu.0000242600.23386.1a.

Abstract

Breast accumulation of I-131 may be an undesirable effect of I-131 ablation in postpartum women being treated for differentiated thyroid cancer. The use of diagnostic I-123 scintigraphy before ablation does allow an assessment of potential postablative breast uptake in such patients. This case series of 8 patients evaluates I-123 scintigraphy in the assessment of breast uptake in postpartum women with thyroid cancer. Of these patients, 7 were studied at various times after cessation of lactation and in one patient, lactation was not initiated at all. Of the group who did not receive lactation-inhibiting medications, there was variable breast uptake demonstrated and by 6 months postcessation of lactation, some patients showed persisting breast uptake but others demonstrated no uptake. In the group treated with lactation-inhibiting medications, such as bromocriptine or cabergoline, breast uptake appears to be reduced much earlier with uptake becoming absent after as little as 3 weeks of treatment. There was barely discernible uptake in the patient in whom lactation was never initiated. I-123 scintigraphy may help guide clinicians on the appropriate timing of radioiodine ablation to help minimize concentration of I-131 in breast tissue.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Breast / diagnostic imaging*
  • Breast / metabolism*
  • Female
  • Humans
  • Iodine Radioisotopes / pharmacokinetics*
  • Iodine Radioisotopes / therapeutic use
  • Radiation Protection / methods*
  • Radiometry / methods
  • Radionuclide Imaging
  • Radiopharmaceuticals / pharmacokinetics
  • Radiopharmaceuticals / therapeutic use
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted / methods
  • Risk Assessment / methods
  • Risk Factors
  • Thyroid Neoplasms / diagnostic imaging*
  • Thyroid Neoplasms / metabolism
  • Thyroid Neoplasms / radiotherapy*
  • Time Factors

Substances

  • Iodine Radioisotopes
  • Radiopharmaceuticals