title: Prediction of lack of response to neoadjuvant chemotherapy in rare breast tumour histology with Tc-99m sestamibi scintimammography.
abstract: The authors report a case of a 47-year-old female with a malignant lump in the right breast and ipsilateral axillary nodal involvement. She was pathologically misinterpreted as a case of ductal cell carcinoma with papillary component on fine needle aspiration cytology (FNAC) pre-operatively. On lines of the FNAC report, the patient underwent scintimammography (SMM) for prediction of treatment response based on washout pattern. The SMM revealed rapid washout of radiotracer predictive of poor responder. Despite unfavourable result seen with SMM, the patient received 4 cycles of neo-adjuvant chemotherapy (NACT). However, there was no clinical response after chemotherapy. The post-surgical histopathology revealed the actual histology to be pleomorphic liposarcoma. This case highlights that SMM has the ability to predict non-responsiveness of unusual tumour histology to standard NACT.
authors.affiliation: Nuclear Medicine Centre, Department of Radiotherapy, Indira Gandhi Medical College, Shimla, India. sood99@yahoo.com
authors.forename: Ashwani
authors.initials: A
authors.lastname: Sood
authors.forename: Rajeev K
authors.initials: RK
authors.lastname: Seam
authors.forename: Kavita
authors.initials: K
authors.lastname: Mardi
authors.forename: Manoj K
authors.initials: MK
authors.lastname: Gupta
authors.forename: Sandeep
authors.initials: S
authors.lastname: Sethi
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D044584:Carcinoma, Ductal / Q000000981:diagnostic imaging; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008080:Liposarcoma / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D057234:Preoperative Period; D011877:Radionuclide Imaging; D017256:Technetium Tc 99m Sestamibi; D016896:Treatment Outcome
chemical_list: D017256:Technetium Tc 99m Sestamibi