eMedicineLive

Breast cancer is the leading cancer affecting women in western countries. For treating breast cancer, it is important to know the estrogen receptor (ER) status of the patient. This is because patients with a positive ER status respond favorably to anti-hormonal therapy. The ER status of the patient is known by immune-histo-chemical staining of a sample tissue obtained from the tumor. However, staining of sample from primary tumor predicts the response to anti-hormonal therapy in only 50-60% patients. Moreover, the estrogen receptors are distributed in a heterogeneous manner in the tumor. So, the evaluation of ER status may be false negative. Moreover, obtaining repeated biopsies for determining ER status may lead to further spread of an invasive form of cancer, surgeons fear. That is the reason why doctors were looking for a non-invasive method to determine the ER status of a patient.

 

Scientists from the Department of Oncology, University Medical Center, Groningen, Netherlands, have found that PET imaging of the whole body using 16alfa- 18 F- fluoro- 17 beta- estradiol (18F- FES) can obtain information about the ER status of the patient in a non- invasive manner. The researchers evaluated 33 patients who underwent 18F- FES PET between December 2008 and October 2010. The imaging technique was used to find cancerous lesions, ER status in metastatic patients and the origin of metastasis.

 

22 patients showed 18F- FES positive lesions. The technique was useful in detecting 341 bone lesions compared to 246 lesions by conventional imaging. It improved diagnostic understanding in 88% of the patients and 48% of the patients had to undergo a change in their treatment because of it. The researchers have concluded that 18F- FES pet imaging can play an important role in cases where the standard work-up has not been able to determine the ER status of the patient. It can also be important in deciding the course of treatment in such patients.

 

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