INTRODUCTION: The primary end--point of the study was to established the role of sestamibi scintimammography and PET/CT findings in locally advanced @entity0 (LABC) before neoadjuvant systemic therapy (NST) in different histological subtypes. The secondary end--point was to determine the role of FDG PET/CT as multi drug resistance marker. METHODS:From January 2012, we prospectively enrolled 51 consecutive @entity1 (median age: 49 years;; range: 27--76 yrs) with a biopsy--proven LABC. All @entity1 underwent both sestamibi scintimammography and FDG PET/CT within one week before to start NST. Both examinations were qualitatively and semiquantitatively analysed. For scintimammography we calculated the @entity5 to background ratio (T/B) and the most intense uptake of the @entity5 to background ratio (I/B) according the following formula: T/B=[cntsT--cntsB]/ [cntsB] and I/B [cntsI--cntsB]/ [cntsB]. Furthermore, the percentage washout index (WO) for T and I were obtained, according to: WOT,I= [cntsT,I]early image--[cntsT,I]delayed image/[cntsT,I]early image. Maximum and average (avg) standardized uptake value (SUV) was computed by PET/CT, using a region of interest. @entity1 who had an evidence of systemic @entity3 or a second active @entity5 at imaging scans, were excluded. At the end of pre--operative therapy, the response to therapy was assessed by the analysis of surgical specimen and then correlated with both scintimammographic and PET/CT data. RESULTS: Based on the inclusion criteria, the final analysis was performed in 49 @entity1 . Scintimammography and PET/CT showed a sensitivity of 100% for the evaluation of primary @entity5 , while PET/CT showed a slightly higher detection rate for axillary lymph node than scintimammography. According to the biological pattern, SUVmax and SUVavg resulted significantly different among histological subtypes, whereas scintimammographic data did not. At the end of neo--adjuvant therapy, pathological complete response was obtained in 12 (24.4%) @entity1 , while 37 had a partial or no response to NST (identified as no--responders). On the basis of histopathological response to NST, median WOI resulted significantly lower in responders than no--responders, (30.5 vs. 44%; p=0.027). Conversely, SUVmax and SUVavg were significantly higher in responders than no--responders (all p<0.05). In this latter subset of @entity1 , high WOTs were associated with low SUVs. On the contrary, in responder group, high SUVs were reported particularly for high WOT values. CONCLUSIONS: Scintimammography with sestamibi did not accurately determine the responsiveness to therapy. FDG PET/CT is more accurate in the prediction of response to therapy, particularly in the aggressive LABC subtype. Moreover, semiquantitative data by FDG PET seems to be linked with the chemosensitivity to NST.

Staging of locally advanced XXXX and the prediction of response to neoadjuvant chemotherapy: complementary role of scintimammography and 18F-FDG PET/CT.

@entity1 :: ('9606', 'Species') :: ['women', 'Patients', 'patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'cancer'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases']
@entity0 :: (MESH:D001943,Disease) :: ['breast cancer']
