Popova , N., Novikov, S., Krzhivitsky, P., Zhukova, L., Krivorotko, P., Artemyeva, A., Valitova, A., Khoroshavina , A., Chernaya, A., Bryantseva, Z., Akulova, I., Mikhnin, A., Yaganova, T., & Kanaev, S. V. (2023). Diagnostic Capabilities of Scintimammography in Detecting Multicentric and Minimal Breast Cancer of Various Molecular Subtypes. Voprosy Onkologii, 69(4), 708–714. https://doi.org/10.37469/0507-3758-2023-69-4-708-714

Abstract

Aim. To assess sensitivity of SMG/MBI for diagnosis of minimal breast cancer (BC) and multicentric (MC) tumors in patients with different BC subtypes

Material and methods. We analyzed results of SMG/MBI that was performed in 1 080 women (2 154 mammary glands) with suspected BC. Breast imaging was performed 15-20 min after i/v injection of 370-740 MBq of 99mTc-MIBI. Verification of changes was carried out by morphological examination in 1 060 cases, and by dynamic observation in the remaining cases. Minimal forms classified as the lesions up to 10 mm in diameter. Minimal BC was detected in 178 patients. MCBC was diagnosed when SMG/MBI revealed two or more foci in different quadrants or within the same quadrant at least 30 mm apart.

Results. Sensitivity of SMG/MBI in diagnosis of minimal BC was 82%. In patients with different biological subtypes of BC, the sensitivity of SMG/MBI was as follows: 76% for luminal А, 80% - luminal В, 91% - luminal В+, 90% - triple negative and 100% for HER2 positive. The sensitivity of SMG/MBI in diagnosis of minimal Triple-negative and HER2-positive BC was significantly higher (p = 0.02).

The frequency of visualizing MCBC varied depending on the biological subtypes -19 cases (20.2%) for HER2-positive, which was significantly higher (p = 0.006) compared to other molecular-biological subtypes: Luminal A — 25 cases (10.5%), Luminal B — 41 cases (11.4%), Luminal B+ — 19 cases (12.6%), Triple-negative — 18 cases (10.3%).

Conclusion. SMG/MBI demonstrate the highest sensitivity in diagnosis of minimal BC of most aggressive subtypes (90% in triple-negative and 100% - in HER2-positive BC). 122 patients (12%) had multicentric BC with the highest frequency (20.2 %) in women with HER2-positive BC.

https://doi.org/10.37469/0507-3758-2023-69-4-708-714

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