title: Use of a portable gamma camera for guiding surgical treatment in locally advanced breast cancer in a post-neoadjuvant therapy setting.
abstract: The aim of the present study was to assess the feasibility of a portable gamma camera (PGC) for guiding surgical treatment in locally advanced breast cancer (LABC) after neoadjuvant therapy (NT). Since January 2012, a PGC (Sentinella 102, ONCOVISION) has been available in our center. We planned to perform a feasibility monocentric prospective study involving 15-20 patients with LABC for assessing the diagnostic performance of this PGC after NT (Breast Cancer Surgery-S102). Before the surgical treatment and at the end of NT an injection of 99mTc-Sestamibi (100-150 MBq) was made. Conventional scintimmamography (SMM) and Sentinella 102 images were obtained from 18 patients. 10 (55.5 %) patients showed a focal uptake of tracer in the breast or lymph nodes before or after the surgical excision (on histological specimen), while 8 did not. The histological specimen concluded for a complete response to NT in 4 (22.2 %) patients and for a partial or no response to treatment in the remnant 14 subjects. The specificity and false-negative rate of the Sentinella 102 compared to SMM were 100 % for both and 38 % vs. 60 %, respectively. The global diagnostic accuracy of Sentinella 102 was: 66.7 % (95 % confidence interval: 44.88-88.44 %). The present feasibility study shows how a new nuclear imaging device can be useful in the operating theatre for guiding a radical surgery approach in patients with LABC after NT.
authors.affiliation: Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Via Gattamelata, 64 35128, Padua, Italy, laura.evangelista@ioveneto.it.
authors.forename: Laura
authors.initials: L
authors.lastname: Evangelista
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Cervino
authors.forename: Riccardo
authors.initials: R
authors.lastname: Sanco
authors.forename: Michele
authors.initials: M
authors.lastname: Bignotto
authors.forename: Tania
authors.initials: T
authors.lastname: Saibene
authors.forename: Silvia
authors.initials: S
authors.lastname: Michieletto
authors.forename: Cristina
authors.initials: C
authors.lastname: Ghiotto
authors.forename: Fernando
authors.initials: F
authors.lastname: Bozza
authors.forename: Marta
authors.initials: M
authors.lastname: Paiusco
authors.forename: Giorgio
authors.initials: G
authors.lastname: Saladini
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D017256:Technetium Tc 99m Sestamibi; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017256:Technetium Tc 99m Sestamibi