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ORIGINAL ARTICLES  BREAST CANCER II 

The Quarterly Journal of Nuclear Medicine 1998 March;42(1):43-8

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Skeletal scintigraphy in breast cancer management

Bares R.

From the Department of Nuclear Medicine Eberhard-Karls-University, Tuebingen,Germany


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Since its intro­duc­tion in 1971 ­bone scin­tig­ra­phy has ­become the clas­si­cal pro­ce­dure to con­firm or ­exclude met­a­stat­ic ­spread of ­breast can­cer to skele­ton. Recent devel­op­ments in tom­o­graph­ic imag­ing (CT, MRI) as ­well as a ­more crit­i­cal atti­tude ­towards tech­ni­cal diag­nos­tic ­tests ­have ­raised the ques­tion ­about the ­present ­role of scin­tig­ra­phy in stag­ing and fol­low-up of ­breast can­cer ­patients. Based ­upon system­at­ic ret­ro­spec­tive anal­y­ses ­bone scin­tig­ra­phy is rec­om­mend­ed for the ­initial stag­ing of ­high ­risk ­patients (­node-pos­i­tive). In the fol­low-up of symp­tom-­free ­patients ­bone scin­tig­ra­phy did not ­prove to be nec­es­sary ­while it ­should be ­used in symp­to­mat­ic ­patients to con­firm and dem­on­strate the ­extent of met­a­stat­ic dis­ease. The ­bone ­scan is ­also use­ful for treat­ment con­trol. How­ev­er, due to sim­i­lar find­ings in ­case of ­response (­flare phe­nom­e­non) as ­well as ­tumor pro­gres­sion clin­i­cal rel­e­vance ­appears to be lim­it­ed. In ­future increas­ing com­pe­ti­tion ­with CT and/or MRI ­will prob­ably ­occur. Since MRI was prov­en to be ­more sen­si­tive as ­well as spe­cif­ic in ­direct com­par­i­son, all ­efforts ­should be ­made to ­improve ­image qual­ity and to ­reduce ­costs of skel­e­tal scin­tig­ra­phy. PET ­using F-18 flu­o­ride ­might be an inter­est­ing alter­na­tive, if it ­becomes avail­able for rea­son­able pric­es.

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