Every 2,5 minutes a woman is diagnosed with breast cancer. Every 7,5 minutes a woman dies from the disease.
Complete cure is possible for more and more women, with earlier diagnosis and improved, less aggressive treatments. Cross Specialty teams, with surgeons, gynecologists, nuclear medicine physicians, radiologists, pathologists, oncologists, nurses and researchers are making it possible.
Victory is at hand for many women and their families, but not yet for everyone, as there is still significant mortality. Not every treatment is definitive, and there are still some recurrences, both local and at a distance, in up to 25% of patients.
Improving survival and care is the objective, and technology can help the professionals who are taking care of every woman at screening, diagnosis or treatment.
Breast cancer, the most frequent malignant tumor in women, is receiving growing health focus around the world, still with many inequalities. Its treatment is supported by a host of technological and clinical options.
From the basic self-exploration or X-Ray screening to the sophisticated stereotactic prone tables or the MRI programs for early detection in groups of women at increased risk, there are several options, each with clinical and economic pros and cons, and classified as either morphological (detect abnormal anatomy) and functional (detect abnormal metabolic activity, often BEFORE anatomical change).
Some technologies, however, are more commonly used in different phases of disease progression and continuum of care.
Whole-body PET has been confirmed, after some early conflicting reports about its sensitivity and poor resolution, as “very valuable“ at multiple stages in breast cancer assessment, and a key element, complementary and often superior to others, in diagnosing palpable masses, staging of tumors and lymph nodes, tumor characterization, long term follow up, assessment of results of chemotherapy, identification of distant metastases.
A major exclusive advantage is its quantification of metabolism and tumor activity, avoiding many false positives vs MRI. Its major limitation is its low resolution, often above 5 mm.
STRONG POSITIVE REPORTS…
PET´s sensitivity, specificity, positive predictive value and negative predictive value in detecting primary breast cancer are all well above 90%.
…AND STILL SOME DOUBTS…
Multiple investigators report a reduced ability of whole-body PET to detect small, well-differentiated in situ breast carcinoma (<1 cm)...
...LED TO THE POSITION OF MANY PROTOCOLS
As primary breast cancer detection requires the ability to depict occult, non palpable, small (<1 cm) invasive and in situ malignant lesions, Whole-body PET is not often used today in primary breast cancer detection.
Whole-body PET can detect distant metastasis and assess the axilla, PEM are offering unprecedented resolution, specificity and convenience, both for diagnosis, characterization and follow up of both invasive and in situ, ductal or lobullar carcinomas:
Early studies demonstrated that PEM is capable of imaging smaller breast cancers than standard Whole-body PET.
The classical mammography position can be less effective (due to breast compression) in small breasts, lesions near thoracic wall, and located in superior external quadrant, as well as very low captation tumors.