title: Is MUGA scan necessary in patients with low-risk breast cancer before doxorubicin-based adjuvant therapy? Multiple gated acquisition.
abstract: Doxorubicin-based chemotherapy in the adjuvant treatment of breast cancer has become standard. Use of doxorubicin is limited by cardiac dysfunction; however, the incidence is dramatically reduced by limiting the dose to less than 550 mg/m(2). Although the cumulative dose in breast cancer is typically 240 mg/m(2), multiple gated acquisition (MUGA) scans are still recommended for determining cardiac functional status in these patients. To examine the need for this practice, we reviewed 296 patients who underwent surgery for breast cancer at Roswell Park Cancer Institute between July 1997 and December 1998. Fifty-nine of 95 (62%) patients receiving doxorubicin-based regimens, and 3 of 39 (7%) receiving nondoxorubicin regimens had pretreatment MUGA scans. The MUGA scans showed normal results in 58 patients and low-normal in 4 (6.5%), with no wall motion abnormalities encountered. There were no cases where doxorubicin was not used because of an abnormal MUGA scan. There were no cardiac complications in the 59 women who received doxorubicin-based chemotherapy. MUGA will screen out few, if any, women under consideration for doxorubicin-based adjuvant therapy; the decision to avoid doxorubicin can be made based on age and preexisting comorbidity. Guidelines recommending routine use of MUGA before the administration of doxorubicin for adjuvant therapy for breast cancer should be reconsidered.
authors.affiliation: Department of Surgery, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Sabel
authors.forename: E G
authors.initials: EG
authors.lastname: Levine
authors.forename: T
authors.initials: T
authors.lastname: Hurd
authors.forename: G N
authors.initials: GN
authors.lastname: Schwartz
authors.forename: R
authors.initials: R
authors.lastname: Zielinski
authors.forename: D
authors.initials: D
authors.lastname: Hohn
authors.forename: S B
authors.initials: SB
authors.lastname: Edge
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D015637:Gated Blood-Pool Imaging; D006331:Heart Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D004317:Doxorubicin