title: Timing and potential role of diagnostic I-123 scintigraphy in assessing radioiodine breast uptake before ablation in postpartum women with thyroid cancer: a case series.
abstract: Breast accumulation of I-131 may be an undesirable effect of I-131 ablation in postpartum women being treated for differentiated thyroid cancer. The use of diagnostic I-123 scintigraphy before ablation does allow an assessment of potential postablative breast uptake in such patients. This case series of 8 patients evaluates I-123 scintigraphy in the assessment of breast uptake in postpartum women with thyroid cancer. Of these patients, 7 were studied at various times after cessation of lactation and in one patient, lactation was not initiated at all. Of the group who did not receive lactation-inhibiting medications, there was variable breast uptake demonstrated and by 6 months postcessation of lactation, some patients showed persisting breast uptake but others demonstrated no uptake. In the group treated with lactation-inhibiting medications, such as bromocriptine or cabergoline, breast uptake appears to be reduced much earlier with uptake becoming absent after as little as 3 weeks of treatment. There was barely discernible uptake in the patient in whom lactation was never initiated. I-123 scintigraphy may help guide clinicians on the appropriate timing of radioiodine ablation to help minimize concentration of I-131 in breast tissue.
authors.affiliation: Department of Nuclear Medicine, Royal North Shore Hospital, St. Leonards, Australia.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Brzozowska
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Roach
mesh_terms: D000328:Adult; D001940:Breast / Q000000981:diagnostic imaging* / Q000378:metabolism*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000493:pharmacokinetics* / Q000627:therapeutic use; D011835:Radiation Protection / Q000379:methods*; D011874:Radiometry / Q000379:methods; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics / Q000627:therapeutic use; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000532:radiotherapy*; D013997:Time Factors
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals