Prognostic value of semi-quantitative tumor uptake on Tc-99m sestamibi breast-specific gamma imaging in invasive ductal breast cancer.
OBJECTIVE
This study investigated the prognostic value of preoperative breast-specific gamma imaging (BSGI) uptake measured by a semi-quantitative method in invasive ductal carcinoma (IDC).


METHODS
One hundred and sixty-two women with IDC who underwent preoperative BSGI were retrospectively enrolled. The tumor-to-normal tissue ratio (TNR) was measured on BSGI and correlated with histologic prognostic factors. The prognostic impact of TNR was tested with regard to progression-free survival (PFS) and compared with established prognostic factors.


RESULTS
High TNR was significantly correlated with tumor size >2 cm (p < 0.001), high nuclear grade (p = 0.04), high histologic grade (p = 0.01), axillary node positivity (p = 0.04), ER negativity (p = 0.03), HER2 positivity (p = 0.01), and high MIB-1 index (p = 0.001). Among 162 patients, 14 experienced recurrence during mean follow-up time of 34.7 ± 14.9 months. In Kaplan-Meier survival analyses, high TNR (p < 0.001), high nuclear grade (p = 0.02), high histologic grade (p = 0.007), ER/PR negativity (p = 0.003 and p < 0.001, respectively), HER2 positivity (p = 0.01), triple negativity (p = 0.02), and high MIB-1 index (p = 0.02) showed a significant relationship with poor prognosis. Among them, high TNR was an independent poor prognostic factor in a multivariate regression analysis (p = 0.01).


CONCLUSIONS
High BSGI uptake measured by a semi-quantitative method was correlated with diverse poor histologic prognostic factors and was an independent poor prognostic factor in invasive ductal cancer.
Department of Nuclear Medicine, Ewha Womans University School of Medicine, 911-1 Mok-Dong, Yangchun-ku, Seoul, 158-710, Republic of Korea, punsu07@naver.com.
Hai-Jeon
HJ
Yoon
Yemi
Y
Kim
Kyu-Tae
KT
Chang
Bom Sahn
BS
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D001940:Breast / Q000000981:diagnostic imaging*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009928:Organ Specificity; D011379:Prognosis; D011877:Radionuclide Imaging; D012008:Recurrence; D017256:Technetium Tc 99m Sestamibi / Q000378:metabolism*
D017256:Technetium Tc 99m Sestamibi