Bone scintigraphy in the monitoring of treatment effect of bisphosphonates in bone metastatic breast cancer.
OBJECTIVE
The aim of this retrospective study was to assess the possibilities of whole-body bone scintigraphy (WB BSc) in the monitoring of the effect of biphosphonate treatment in patients with breast cancer and bone metastases.


METHODS
51 breast cancer patients with bone metastases, aged from 33 to 73 years, were included.WB BSc was performed on a Siemens DIACAM gamma camera, 2-4 h after i.v. injection of 740 MBq 99mTc-MDP, before the start of the biphosphonate treatment (baseline scintigraphy) with zoledronic acid(Zometa) and at least 6 months thereafter (control scintigraphy) in order to avoid the "flare" effect.


RESULTS
At the baseline WB BSc 41 (80.4%) patients presented with multiple (over 3) bone metastatic lesions, 9 (17.6%) patients with single (up to 3) lesions and 1 (1.96%) patient with a solitary bone metastasis. All bone metastases had osteoblastic appearance. At the control scintigraphy 4 (8%) patients showed complete therapeutic response (CR; no bone lesions were visualized); 21 (41%) patients partial response (PR; decrease in the number and the intensity of the lesions); 16 (31%) patients stable bone lesions (SD; no change in the number or the intensity of the bone metastases); and 10(20%) patients showed disease progression (PD).


CONCLUSIONS
WB BSc is a reliable functional imaging modality for assessment of the biphosphonate therapeutic effect and an important method in the multimodal treatment planning of breast cancer patients.
Chavdarova
L
L
Clinic of Nuclear Medicine, National Hospital of Oncology, Sofia, Bulgaria. dr.lidia.chavdarova@gmail.com
Piperkova
E
E
Tsonevska
A
A
Timcheva
K
K
Dimitrova
M
M
D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000556:secondary; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives*; D051598:Whole Body Imaging
D004164:Diphosphonates; D019275:Radiopharmaceuticals; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013669:Technetium Tc 99m Medronate