ORIGINAL ARTICLES  BREAST CANCER II 

The Quarterly Journal of Nuclear Medicine 1998 March;42(1):33-42

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Radioimmunolocalization of primary and metastatic breast cancer

Baum R. P., Brummendorf T. H.*

From the Department of Nuclear Medicine University Medical Center Frankfurt/Main, Germany and the *Department of Hematology Oncology and Immunology University Medical Center, Tübingen, Germany

The appro­pri­ate ther­a­py for ­breast can­cer ­depends main­ly ­upon ear­ly and reli­able ­tumor detec­tion, cor­rect ­tumor stag­ing and accu­rate re-stag­ing ­after ther­a­py. Current radio­log­i­cal imag­ing meth­ods are ­based pri­mar­i­ly on mor­phol­o­gy result­ing in ­high sen­si­tiv­ity but lack­ing spec­i­fic­ity. Established nucle­ar med­i­cine tech­niques are sen­si­tive but not ­very spe­cif­ic. To ­improve spec­i­fic­ity, a num­ber of mono­clo­nal anti­bod­ies, select­ed ­against a par­tic­u­lar ­tumor-asso­ciat­ed anti­gen ­expressed on the sur­face of ­breast can­cer ­cells, ­have ­been radio­lab­eled for imag­ing in ­vivo ­tumor local­iza­tions. In the­o­ry, radio­im­mu­nod­e­tec­tion ­offers the poten­tial to dem­on­strate can­cer ­cells ­even in sub­ra­dio­log­i­cal dis­ease, or ­when anat­o­my-­based imag­ing meth­ods may be ­unable to dis­tin­guish the ­nature of an evi­dent ­mass, mak­ing the dif­fe­ren­tial diag­no­sis ­between an inflam­ma­to­ry reac­tion, a ­postsur­gi­cal fibro­sis, or a tru­ly ­viable ­tumor impos­sible. Suspected ­tumor recur­rence indi­cat­ed by increas­ing ­tumor mark­er lev­els ­could be ­another clin­i­cal indi­ca­tion for radio­im­mu­nol­o­cal­iza­tion, ­even if stan­dard imag­ing modal­ities are neg­a­tive. A ­large num­ber of anti­bod­ies ­against dif­fer­ent epi­topes of ­human neo­plas­tic ­breast tis­sue ­have ­been inves­ti­gat­ed pre­vi­ous­ly. However, a high­ly spe­cif­ic and sen­si­tive mono­clo­nal anti­body for immu­nos­cin­tig­ra­phy and radio­im­mu­no­ther­a­py has not yet ­been ­found. This ­review address­es tumor­-bi­o­log­i­cal con­sid­er­a­tions, radio­iso­topes and radio­lab­el­ing meth­ods, ­tumor tar­gets and dif­fer­ent mono­clo­nal anti­bod­ies ­used for immu­nos­cin­tig­ra­phy (­incl. ­SPECT amd PET) of ­breast can­cer.