title: The potential role of Calcitonin Gene-Related Peptide (CGRP) in breast carcinogenesis and its correlation with 99mTc-(V)DMSA scintimammography.
abstract: OBJECTIVE
  Experimental data suggest a role for calcitonin gene-related peptide (CGRP) in normal breast development and angiogenesis. This pilot study correlated CGRP with neoangiogenesis and the uptake of the tumor-seeking, proliferation-imaging radiotracer pentavalent technetium-99m dimercaptosuccinate (99mTc-(V)DMSA) in invasive and preinvesive breast lesions.
  
  
  METHODS
  Among women evaluated preoperatively by 99mTc-(V)DMSA scintimammography, 29 invasive ductal carcinomas (IDCs) were retrospectively studied: 15 isolated (Group I); 14 mixed with preinvasive pathologies (ductal carcinoma in situ [DCIS] and/or epithelial hyperplasia [EH]; Group M). CGRP staining and neoangiogenesis were compared between invasive and DCIS/EH regions and were correlated. 99mTc-(V)DMSA displayed a diffusely increased uptake pattern corresponding to DCIS/EH; its lesion-to-background (L/B) ratio was compared between images acquired at 10 and 60 minutes and its retention ratio (RR) was correlated with CGRP.
  
  
  RESULTS
  Seven of 15 group I and 10 of 14 group M patients (58.6% of the population) were CGRP-positive. CGRP was prevalent in the DCIS/EH component of mixed-lesions (even in the surrounding normal epithelium of nearly half), with declining intensity as advancing from DCIS/EH to high-grade IDC. Similarly, neoangiogenesis was considerably higher in DCIS/EH than in group I pure IDCs. A significant CGRP-neoangiogenesis correlation was verified only in group I. The diffuse 99mTc-(V)DMSA uptake exhibited significant, time-related L/B increase and a RR positively correlating with CGRP.
  
  
  CONCLUSIONS
  CGRP expression and neoangiogenesis are intensified in mixed invasive-preinvasive breast lesions; an underlying relation may exist, requiring further investigation. CGRP also appears associated with 99mTc-(V)DMSA's propensity to depict preinvasive pathologies. This relationship could denote an additional proliferative role for CGRP.
authors.affiliation: Department of Nuclear Medicine, Alexandra University Hospital, Athens, Greece.
authors.forename: Vassilios
authors.initials: V
authors.lastname: Papantoniou
authors.forename: Spyridon
authors.initials: S
authors.lastname: Tsiouris
authors.forename: Maria
authors.initials: M
authors.lastname: Sotiropoulou
authors.forename: Pipitsa
authors.initials: P
authors.lastname: Valsamaki
authors.forename: John
authors.initials: J
authors.lastname: Koutsikos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Ptohis
authors.forename: Constantine
authors.initials: C
authors.lastname: Dimitrakakis
authors.forename: Evaggelia
authors.initials: E
authors.lastname: Sotiropoulou
authors.forename: Maria
authors.initials: M
authors.lastname: Melissinou
authors.forename: Lydia
authors.initials: L
authors.lastname: Nakopoulou
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
authors.forename: Cherry
authors.initials: C
authors.lastname: Zerva
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D015740:Calcitonin Gene-Related Peptide / Q000378:metabolism*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000378:metabolism; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging* / Q000378:metabolism; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008327:Mammography / Q000379:methods*; D010865:Pilot Projects; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D019783:Technetium Tc 99m Dimercaptosuccinic Acid
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D015740:Calcitonin Gene-Related Peptide