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Breast cancer
Definition
Breast cancer manifests itself with an uncontrollable, growth of abnormal cells within the breast. It occurs in both genders, although it is
rare in men (Discovermi.org - SNM, 2011).
According to the American Cancer Society it is estimated that in 2011, there were more than 230,480 new cases of invasive breast
cancer diagnosed and about 39,000 expected deaths. (American Cancer Society) It is essential that physicians accurately locate the
primary tumor(s) and determine whether the cancer has metastasized when deciding on the best treatment for their patients.
Role of molecular imaging
There are a variety of imaging technologies available today to detect and evaluate breast cancer. For diagnosis, mammography or
clinical breast examination are the usual preferred methods, although MRI, ultrasound, breast scintigraphy and Positron Emission
Mammography, or PEM, have been known to be useful in imaging women with dense breasts as well as assisting in guided biopsy.
After diagnosis, there are imaging options to help with the initial staging to detect areas of metastasis in the lungs, liver, bones, brain
and lymph nodes (Where breast cancer might come back and how to detect it, 2011). However, molecular imaging in breast cancer
is useful not only in determining the aggressiveness or extent of disease, but in response to treatment as well (Discovermi.org - SNM,
2011):
 Positron emission mammography (PEM)
 Molecular image-guided sentinel node biopsy
 Lymphatic mapping
 Breast Scintigraphy or Breast – specific gamma imaging (BSGI) (Discovermi.org - SNM, 2011)
 Nuclear medicine and PET bone scan
 Bone palliative therapy
 Liver – Spleen Scan
Molecular imaging can also be used to assess the condition of the heart for breast cancer patients. After staging, a multiple gated
acquisition (MUGA) may be performed in patients who will need chemotherapy to assess ejection fraction in the heart. This scan
provides an accurate and reproducible means of measuring and monitoring the left ventricular ejection fraction. LVEF calculates the
amount of blood your left ventricle pumps every time your heart beats. (MUGA Scans and Anthracyclines, 2009).
Radiopharmaceutical
Manufacturer
Trade names
Approved indications in adults
Technetium-99m sulfur colloid
Pharmalucence
To assist in the localization of lymph nodes
draining a primary tumor in patients with breast
cancer when used with a hand-held gamma
counter Imaging areas of functioning
reticuloendothelial cells in the liver and spleen
Fluorine-18 sodium fluoride
Various
PET bone imaging agent to delineate areas of
altered osteogenesis activity
Samarium-153 lexidronam
EUSA Pharma
Quadramet
®
Indicated for relief of pain in patients with
confirmed osteoblastic metastatic bone lesions
that enhance on radionuclide bone scan
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CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their
respective owners.
.
Radiopharmaceutical
Manufacturer
Strontium-89 chloride
Bio-Nucleonics
GE Healthcare
Metastron
Technetium-99m medronate
Bracco Diagnostics
DRAXIMAGE
GE Healthcare
Pharmalucence
MDP-Bracco
MDP-25
MDP Multidose
MDP Multidose
Technetium-99m oxidronate
Covidien
Technescan HDP
Technetium-99m
pyrophosphate
Covidien
Pharmalucence
Technescan PYP
Technetium-99m red blood
cells
Covidien
Technetium-99m sestamibi
Cardinal Health
Covidien
DRAXIMAGE
Lantheus Medical
Imaging
Pharmalucence
Technetium Tc 99m
tilmanocept
Navidea
Biopharmaceuticals,
Inc.
Trade names
Approved indications in adults
Indicated for the relief of bone pain in patients
with painful skeletal metastases that have been
confirmed prior to therapy
TM
TM
As a bone imaging agent to delineate areas of
altered osteogenesis
TM
TM
UltraTag
As a bone imaging agent to delineate areas of
altered osteogenesis
Tc99m-labeled red blood cells are used for:
 Blood pool imaging including cardiac
first pass and gated equilibrium
imaging
TM
Planar breast imaging as a second line
diagnostic drug after mammography to assist in
the evaluation of breast lesions in patients with
an abnormal mammogram or a palpable breast
Cardiolite®
Lymphoseek
TM
As a bone imaging agent to delineate areas of
altered osteogenesis (adult and pediatric use)
®
Lymphoseek (technetium Tc 99m tilmanocept)
injection is a radioactive diagnostic agent
indicated with or without scintigraphic imaging
for:
 Lymphatic mapping using a handheld
gamma counter to locate lymph nodes
draining a primary tumor site in
patients with solid tumors for which this
procedure is a component of
intraoperative management.
 Guiding sentinel lymph node biopsy
using a handheld gamma counter in
patients with clinically node negative
squamous cell carcinoma of the oral
cavity, breast cancer or melanoma.
MSDS and package insert information
© 2015 Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO
CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their
respective owners.
.