The evaluation of combined scintimammography and tumor markers in breast cancer patients.
BACKGROUND
Breast cancer is the second most common cancer in Thai women. Mammography is the method of choice for early detection but scintimammography (SMM) is sometimes helpful. Many tumor markers are important in the follow-up of treatment.


METHODS
47 breast cancer patients (36 for preoperative evaluation, others for postoperative investigation) were studied with SMM using 201Tl and/or 99mTc-MIBI and serum CEA and CA15-3.


RESULTS
SMM could pick up breast cancer in 91.7% of the patients with intact breast masses and 2/2 cases of local recurrence. The uptake ratio tended to increased from stage 2A through 3B. Sensitivity of SMM to detect axillary node uptake was only 44.4%. SMM had no role in the evaluation of the postoperative period unless there was no evidence of palpable recurrent disease. No definite correlation between serum CEA and CA15-3 levels was observed. Elevated CA15-3 is a good indicator for recurrent and metastatic breast diseases and more specific than CEA in clinical correlations.


CONCLUSIONS
SMM may be helpful when mammographic results are questionable. SMM can detect primary breast cancers and recurrent lesions that are palpable with high sensitivity. Increased tumor-uptake ratio and rising serum tumor markers, more often seen with elevated CA15-3 rather than CEA, could be useful for the prognosis of breast cancer patients. Even though CA15-3 is not reliable for the early detection of breast cancer, it is very helpful for monitoring therapeutic response since its level correlates with the clinical state better than CEA.
Mangkharak
J
J
Department of Radiology, Faculty of Medicine, Siriraj Hospital, Bangkoknoi, Bangkok, Thailand.
Patanachak
C
C
Podhisuwan
K
K
Pleehachinda
R
R
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002272:Carcinoembryonic Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008327:Mammography; D008875:Middle Aged; D018396:Mucin-1 / Q000097:blood*; D009362:Neoplasm Metastasis; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012008:Recurrence; D012016:Reference Values; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes
D002272:Carcinoembryonic Antigen; D018396:Mucin-1; D013794:Thallium Radioisotopes; D017256:Technetium Tc 99m Sestamibi