Tc-bis-folate Cysteamide, a Receptor Targeted Diagnostic Agent in diagnosing breast cancer

Introduction: Breast cancer is the most common malignancy in women. Early detection of the tumor is important for better management decisions. overexpression of folate receptors are noted in some malignancies such as breast cancer. Folate receptor targeting, for diagnostic purposes has recently been investigated in cancer studies.Methods: 28 women, aged 18 to 66 years old, with breast masses of unknown nature, were enrolled in this study. After intravenous injection of 740MBq 99mTc -bis-folate cysteamide, scintimammography was performed using a gamma camera imaging device. Tru-cut needle biopsy of the breast lesions were performed after cintimammography. All scintimammograms were analyzed by a nuclear medicine specialist who was blinded to the clinical status, physical examination and radiological findings of the patients. Results : 3 of the patients were excluded from the study due to technical problems in the kit preparation. Histopathologic reports showed that breast masses were benign in 16 (57.1%) patients and malignant in 12 (42.9%) patients. In patients with benign masses (based on pathology reports), all the SPECT images were negative as well as planar images and for all three malignant lesions with negative planar scans, the SPECT studies were positive. Other 9 patients with malignant masses showed positive planar scans. Based on the results, Diagnostic Sensitivity, specificity and PPV were 100% and NPV was 89.2% . Conclusion: Results demonstrated that imaging modality using 99mTc -bis-folate Cysteamide may be suitable for differentiating malignant lesions of the breast from benign ones. This method has high sensitivity and specificity for clinical purposes.