MODULE 3. Further laboratory and imaging examinations related to breast cancer diagnostics
7. Nuclear Medicine
Nuclear Medicine
Nuclear medicine uses radiopharmaceuticals (pharmaceutical that contains one or more radioactive particles (Aerts et al. 2014)) with the purpose to diagnose and treat different pathologies.
Radiopharmaceuticals consist of a transport molecule – a pharmaceutical that follows a physiologic or metabolic process to be examined and incorporates a radioactive nuclide – the radioisotope or radionuclide that emits radiation.
The detection of the radiation emitted by the radionuclide, with specific imaging equipment, such as the gamma-camera or the PET tomographer, allows the tracking of the physiologic or metabolic process through the imaging obtained.
Ultimately, the radiopharmaceutical accumulates in pathological areas, highlighting in the images the location and extension of the disease.
Radiopharmaceuticals consist of a transport molecule – a pharmaceutical that follows a physiologic or metabolic process to be examined and incorporates a radioactive nuclide – the radioisotope or radionuclide that emits radiation.
The detection of the radiation emitted by the radionuclide, with specific imaging equipment, such as the gamma-camera or the PET tomographer, allows the tracking of the physiologic or metabolic process through the imaging obtained.
Ultimately, the radiopharmaceutical accumulates in pathological areas, highlighting in the images the location and extension of the disease.
Nuclear Medicine in Breast Cancer
During the last decade, the prognosis and survival rate of breast cancer patients has improved, mainly due to the early detection, the better understanding of the pathophysiology and the enhancement of surgical and medical therapies (Chen et al. 2017; Rahman 2015).
However, during the early stage, women with breast cancer are susceptible to develop metastatic disease (Jemal et al. 2011; Lu &Kang 2007), which is assessed by physical examination or other specific techniques when symptoms are present or in locally advanced breast cancer (Senkus E et al. 2015).
At this stage, one of the most critical steps is determining whether the cancer has spread to the regional lymph nodes (Rahman 2015; He et al. 2016), specifically to the sentinel lymph nodes (SLN), the regional nodes that directly drain lymph from the primary tumour and the first nodes to receive lymph-borne metastatic cells (Keshtgar 1999).
Since the extent of the involvement of the SLN in breast cancer metastasizing is considered to be a strong predictor of recurrences and survival(Coleman & Rubens 1987; Giammarile et al. 2013), SLN mapping and biopsy contribute to the development of less-invasive surgical procedures (Giammarile et al. 2013).
Lymphoscintigraphy is a highly accurate method for the SLN detection and localization (97%)(Krag et al. 1998), allowing the surgeon to easily identify and biopsy a SLN(Giammarile et al. 2013).
However, during the early stage, women with breast cancer are susceptible to develop metastatic disease (Jemal et al. 2011; Lu &Kang 2007), which is assessed by physical examination or other specific techniques when symptoms are present or in locally advanced breast cancer (Senkus E et al. 2015).
At this stage, one of the most critical steps is determining whether the cancer has spread to the regional lymph nodes (Rahman 2015; He et al. 2016), specifically to the sentinel lymph nodes (SLN), the regional nodes that directly drain lymph from the primary tumour and the first nodes to receive lymph-borne metastatic cells (Keshtgar 1999).
Since the extent of the involvement of the SLN in breast cancer metastasizing is considered to be a strong predictor of recurrences and survival(Coleman & Rubens 1987; Giammarile et al. 2013), SLN mapping and biopsy contribute to the development of less-invasive surgical procedures (Giammarile et al. 2013).
Lymphoscintigraphy is a highly accurate method for the SLN detection and localization (97%)(Krag et al. 1998), allowing the surgeon to easily identify and biopsy a SLN(Giammarile et al. 2013).