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Molecular imaging to guide breast cancer surgery

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Abstract

Purpose

This mini-review aims to provide an overview of the current role of molecular imaging to guide surgery in patients with breast cancer, in non-palpable primary tumours as well as in the management of the axilla in early-stage cancers and when patients receive neoadjuvant systemic therapy.

Methods

Literature research in the PubMed/MEDLINE database was carried out to identify relevant studies evaluating molecular imaging to guide surgery in breast cancers including molecular breast imaging; breast-specific PET systems; radioguided occult lesion localisation; sentinel node and occult lesion localisation; radioactive seed localisation; sentinel lymph node biopsy and marking axillary lymph nodes with radioactive iodine seeds procedure.

Results

We summarised the most relevant results on molecular imaging to guide surgery in breast cancers focusing on indications, technical aspects, accuracy and future perspectives.

Conclusions

Several interventional nuclear medicine techniques are currently available for the management of patients affected by breast cancer in different clinical settings. They provide diagnostic advantages in sub-centimetric lesions or low-grade tumours and help to guide biopsy, also identifying the area with the highest degree of perfusion or metabolism. Nevertheless, some of them are too expensive and not widely spread in hospitals or clinicians still lack confidence in their usage. Further studies are needed to optimise their role in everyday clinical practice.

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Authors and Affiliations

  1. Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Rome, Italy

    Elisabetta Perrone & Daniela Di Giuda

  2. Nuclear Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Angela Collarino & Daniela Di Giuda

  3. Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands

    Lenka M. Pereira Arias-Bouda

  4. Department of Nuclear Medicine, Alrijne Ziekenhuis, Leiderdorp, The Netherlands

    Lenka M. Pereira Arias-Bouda

  5. Department of Pathology, Alrijne Ziekenhuis, Leiderdorp, The Netherlands

    Wietske den Hartog

  6. Department of Life Science and Public Health, Section Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy

    Giorgia Garganese

  7. Gynecologic Oncology Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Giorgia Garganese

  8. Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands

    Jos A. Van der Hage

  9. Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria

    Francesco Giammarile

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  1. Elisabetta Perrone
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  2. Angela Collarino
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Correspondence to Daniela Di Giuda.

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Perrone, E., Collarino, A., Pereira Arias-Bouda, L.M. et al. Molecular imaging to guide breast cancer surgery. Clin Transl Imaging 11, 521–531 (2023). https://doi.org/10.1007/s40336-023-00587-z

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