Place of Bone Scintigraphy in the Assessment of Extension and Follow-Up of Breast Cancer in Senegal: Study of 165 Cases in the Nuclear Medicine Department of Idrissa Pouye General Hospital (Dakar)
Introduction: Breast cancer is the most common cancer in women worldwide, accounting for an estimated 22% of all female cancers. It is the leading cause of cancer mortality in women, almost all of which is due to metastases, with 73% of metastases occurring in the bone. In oncology, metastable technetium 99-labelled methylene bisphosphonate bone scintigraphy (BS) remains the standard examination for detecting and assessing the extent of bone metastases. The aim of this study was to assess the role of BS in the evaluation and follow-up of breast cancer in Senegal. Methodology: This was a retrospective study of breast cancer patients who underwent bone scintigraphy with 99mTc-HMDP in the nuclear medicine department of Idrissa Pouye General Hospital (IPGHO), from July 2009 to June 2022. Results: We enrolled 165 patients, mean age 46.79 years (27 - 87 years). BS was performed in 94.37% of cases for post-therapeutic monitoring and in 5.63% for pre-therapeutic assessment. Results were contributory in 131 patients (92.25%), of whom 72 cases (50.70%) were normal and 59 cases (41.55%) positive or presenting bone metastases; and non-contributory or doubtful in 11 cases (7.75%). Secondary bone locations were multiple in 57 cases (96.61%) and single or solitary in 2 cases (3.39%). The scintigraphic appearance of bone metastases was hyper-fixative in 58 cases (98.31%) and mixed in 1 case (1.69%). Bone lesions were quantified using the Soloway’s grading classification. Conclusion: BS with 99mTc-labelled bisphosphonates remains the examination of choice for skeletal exploration, in the detection and extension of bone metastases in breast cancer. Performance has been enhanced by the development of SPECT coupled with CT (SPECT-CT).
References
[1]
CIRCA: Centre International de recherche sur le Cancer (2020) Rapport sur l’observatoire international sur le cancer. Lyon.
[2]
Chlebowski, R.T., Aragaki, A.K. and Pan, K. (2022) Breast Cancer Prevention and Breast Cancer Mortality. JCO Oncology Practice, 18, 522-523. https://doi.org/10.1200/OP.22.00091
[3]
OMS: Organisation Mondiale de la Santé (2021) Cancer du sein.
[4]
Ban, J., Fock, V., Aryee, D.N.T. and Kovar, H. (2021) Mechanisms, Diagnosis and Treatment of Bone Metastases. Cells, 10, Article 2944. https://doi.org/10.3390/cells10112944
[5]
Łukaszewski, B., Nazar, J., Goch, M., Łukaszewska, M., et al. (2017) Diagnostic Methods for Detection of Bone Metastases. Contemporary Oncology, 21, 98-103. https://doi.org/10.5114/wo.2017.68617
[6]
Talbot, J.N., Paycha, F. and Balogova, S. (2011) Diagnosis of Bone Metastasis: Recent Comparative Studies of Imaging Modalities. The Quarterly Journal of Nuclear Medicine and Molecular Imaging, 55, 374-410.
[7]
Paycha, F. and Richard, B. (2001) Exploration scintigraphie du squelette. Encyclopédie Medico Chirurgicale, 30, 480-490.
[8]
Seyfried, T.N. and Huysentruyt, L.C. (2013) On the Origin of Cancer Metastasis. Critical Reviews in Oncogenesis, 18, 43-73. https://doi.org/10.1615/CritRevOncog.v18.i1-2.40
[9]
Vaz, S.C., Oliveira, C., Teixeira, R., Arias-Bouda, L.M.P., et al. (2023) The Current Role of Nuclear Medicine in Breast Cancer. British Journal of Radiology, 26, Article ID: 20221153 https://doi.org/10.1259/bjr.20221153
[10]
Rong, Y., Ren, H. and Ding, X. (2019) MRI and Bone Scintigraphy for Breast Cancer Bone Metastase: A Meta-Analysis. Open Medicine, 14, 317-323. https://doi.org/10.1515/med-2019-0029
[11]
Diop, O., Ndong, B., Bathily, E.A.L., Sow Diop, W., Senghor, R.S., et al. (2014) Place de la scintigraphie osseuse dans le bilan d’extension des métastases osseuses du cancer du sein au Sénégal: étude préliminaire à propos de 40 cas. Revu Cames Sante, 2, 57-62.
[12]
Bakkali, H., Marchal, C., Lesur-Schwander, A. and Verhaeghe, J.L. (2003) Le cancer du sein chez la femme de 30 ans de moins. Cancer/Radiothérapie, 7, 153-159. https://doi.org/10.1016/S1278-3218(03)00021-0
[13]
Colombie, M., Houdebine, S., Meriaux, E., Kraeber-Bodere, F. and Rousseau, C. (2014) Apport de la médecine nucléaire dans le cancer du sein: à propos d’un cas. Médecine Nucléaire, 38, 375-379. https://doi.org/10.1016/j.mednuc.2014.05.003
[14]
Granier, P. and Mourad, M. (2008) Evaluation par la TEMP-TDM des lésions classées indéterminées en scintigraphie osseuse chez les patients en cancérologie. Médecine Nucléaire, 32, 266-272. https://doi.org/10.1016/j.mednuc.2007.12.003
[15]
Mousseau, M. and Garnier, C. (2002) Cancer du sein: épidémiologie, bilan d’extension, modalités thérapeutiques. Médecine Nucléaire—Imagerie fonctionnelle et métabolique, 26, 7-15.
[16]
Hali, F., Khadir, K.H., Idhammou, W., Bensardi, F.Z., et al. (2011) Manifestations cutanées du cancer du sein chez l’homme. La Presse Médicale, 40, e483-e488. https://doi.org/10.1016/j.lpm.2011.04.010
[17]
Mahjoub, N., Ben Salem, K., Mokrani, A., Mansouri, H., et al. (2021) Epidemiological and Anatomopathological Profile of Breast Cancer in the Region of North-West of Tunisia. La Tunisie Médicale, 99, 441-448.
[18]
Camara, M.A., Coulibaly, S., Traoré, M.M., Ndiaye, M., et al. (2020) Aspects tomodensitométriques des métastases des cancers mammaires dans le Service d’imagerie médicale du CHU Le Luxembourg. Jaccr Africa, 4, 101-107.
[19]
INCA (Institut National du Cancer) (2018) Facteurs de risques du cancer du sein.
[20]
Nkondjock, A. and Ghadirian, P. (2005) Facteurs de risque du cancer du sein. Médecine Sciences, 21, 175-180. https://doi.org/10.1051/medsci/2005212175
[21]
Aouad, L. (2014) Les métastases du cancer du sein à propos de 96 cas colligés à l’institut Joliot Curie de Dakar. Thèse de Docteur en médecine, FMPO-UCAD, Dakar.
[22]
Safini, F., Naqos, N., Bouchbika, Z., Taleb, A., et al. (2017) Le bilan d’extension dans le cancer du sein nouvellement diagnostique: Quels examens pour quelles patientes? Centre d’oncologie et radiothérapie, CHU Ibn Rochd, Casablanca.
[23]
Mhamdi, F., Guerrouj, H., Elrhoul, M. and Ben Rais, N. (2008) Corrélation entre la scintigraphie osseuse et le taux du marqueur tumoral CA15-3 dans le cancer du sein: A propos de 100 cas. Médecine Nucléaire, 32, 76-84.
[24]
Chatti, K., Harrabi, A., Chabchoub, I., Kamoun, T., Sfar, R., et al. (2012) Limites de la scintigraphie osseuse dans le suivi des métastases osseuses du carcinome mammaire: étude du centre tunisien. Médecine Nucléaire, 36, 574-581. https://doi.org/10.1016/j.mednuc.2012.07.008
[25]
Mayi-Tsonga, S., Belembaogo, E., Meye, J.F., et al. (2009) Les cancers du sein au Gabon: Aspects épidémiologiques, diagnostiques et thérapeutiques. Journal Afrique Cancer, 1, 11-15. https://doi.org/10.1007/s12558-008-0003-y
[26]
Watt, G.P., John, E.M., Bandera, E.V., Malone, K.E., Lynch, C.F., Palmer, J.R., et al. (2021) Race, Ethnicity and Risk of Second Primary Contralateral Breast Cancer in the United States. International Journal of Cancer, 148, 2748-2758. https://doi.org/10.1002/ijc.33501
[27]
Hendrick, R.E., Monticciolo, D.L., Biggs, K.W. and Malak, S.F. (2021) Age Distributions of Breast Cancer Diagnosis and Mortality by Race and Ethnicity in US Women. Cancer, 127, 4384-4392. https://doi.org/10.1002/cncr.33846
[28]
Howlader, N., Noone, A.M., Krapcho, M., et al. (2021) Breast Cancer-SEER Incidence Rates by Age at Diagnosis, 2014-2018, by Sex, Observed SEER Incidence Rate, All Races (Includes Hispanic). National Cancer Institute. Bethesda. https://seer.cancer.gov/explorer/
[29]
Bourgana, L. (2010) Cancer du sein chez la femme jeune. A propos de 178 cas. Thèse de Docteur en médecine, FMPO-UCAD, Dakar.
[30]
Bhaludin, B.N., Tunariu, N., Senthivel, N., et al. (2022) Does the Addition of Whole-Body MRI to Routine Imaging Influence Real-World Treatment Decisions in Metastatic Breast Cancer? Cancer Imaging, 22, Article No. 26. https://doi.org/10.1186/s40644-022-00464-4
[31]
Taourel, P., Cyteval, C., Granier, C., Devaux, M. and Suan, A. (2007) Imagerie de la maladie métastatique dans le cancer du sein. In: Cancer du sein avancé, Springer, Paris, 55-66. https://doi.org/10.1007/978-2-287-72615-6_6 https://hal.science/hal-03575123
[32]
Schroeder, H., Hanocq, F., Collignon, J., Colin, P.E., Depuis, Z., et al. (2015) Cancer du sein: Intérêt du bilan d’extension par imagerie lors du diagnostic initial et du suivi les trois premières années après le diagnostic. Revue Médicale de Liège, 70, 140-147.
[33]
Francon, T., Bardet, S., Loiseau, C., Switsers, O., et al. (2008) TEMP/TDM et scintigraphie osseuse en cancérologie: Impact d’une acquisition scannographique basse dose chez les patients avec foyer isolé suspect ou de nature indéterminée. Médecine Nucléaire, 32, 273-280. https://doi.org/10.1016/j.mednuc.2008.01.009
[34]
Abedi, S.M., Mardanshahi, A. and Zeanali, R. (2021) Added Diagnostic Value of SPECT to Evaluate Bone Metastases in Breast Cancer Patients with Normal Whole Body Bone Scan. Caspian Journal of Internal Medicine, 12, 290-293.
[35]
Giammarile, F. (2006) La scintigraphie osseuse. Médecine nucléaire-imagerie fonctionnelle et metabolique, 30, 144-148.
[36]
Costelloe, C.M., Rohren, E.M., Madewell, J.E., et al. (2009) Imaging Bone Metastases in Breast Cancer: Techniques and Recommendations for Diagnosis. The Lancet Oncology, 10, 606-614. https://doi.org/10.1016/S1470-2045(09)70088-9
[37]
Soloway, M.S., Hardeman, S.W., Hickey, D., Raymond, J., et al. (1988) Stratification of Patients with Metastatic Prostate Cancer Based on Extent of Disease on Initial Bone Scan. Cancer, 61, 195-202. https://doi.org/10.1002/1097-0142(19880101)61:1<195::AID-CNCR2820610133>3.0.CO;2-Y
[38]
Ndong, B., Mboth, M., Mbaye, G., Ndoye, O., Bathily, E.H.A.L., et al. (2012) Place de la scintigraphie osseuse dans le bilan d’extension des métastases des cancers de la prostate au Sénégal: étude préliminaire à propos de 45 cas. Médecine Nucléaire, 36, 586-590. https://doi.org/10.1016/j.mednuc.2012.05.012
[39]
Biyi, A., Doudoutt, A., Zekri, A., Caoui, M. and Benrais, M. (2001) Le processus métastatique. Médecine du Maghreb, No. 90, 5-10.
[40]
Coleman, R.E. (2006) Clinical Features of Metastatic Bone Disease and Risk of Skeletal Morbidity. Clinical Cancer Research, 12, 6243-6249. https://doi.org/10.1158/1078-0432.CCR-06-0931
[41]
Iagaru, A. and Minamimoto, R. (2018) Nuclear Medicine Imaging Techniques for Detection of Skeletal Metastases in Breast Cancer. PET Clinics, 13, 383-393. https://doi.org/10.1016/j.cpet.2018.02.002
[42]
Israel, O., Goldberg, A., Nachtigal, A., et al. (2006) FDG-PET and CT Patterns of Bone Metastases and Their Relationship to Previously Administered Anti-Cancer Therapy. European Journal of Nuclear Medicine and Molecular Imaging, 33, 1280-1284. https://doi.org/10.1007/s00259-006-0141-3
[43]
Withofs, N., Collignon, J. and Hustinx, R. (2011) Imagerie des métastases osseuses du cancer du sein. Revue Médicale de Liège, 66, 291-298.
[44]
Ndiaye, M. (2021) Aspects tomodensitométriques des métastases des cancers mammaires dans le service de radiologie du CHUME Le Luxembourg. Master’s Thesis, Universitaire de sénologie, Bamako.
[45]
Mahfouz, H. (2020) Métastases osseuses du cancer du sein: Revue de la littérature. Thèse de Docteur en médecine, Université Mohamed V de Rabat, Maroc.
[46]
Boufettal, H., et al. (2015) Cancer du sein bilatéral synchrone au Maroc: Caractéristiques épidémiologiques et cliniques. Pan African Medical Journal, 20, Article 118. https://doi.org/10.11604/pamj.2015.20.118.6136
[47]
Pulido, C., Vendrell, I., Ferreira, A.R., Casimiro, S., et al. (2017) Bone Metastasis Risk Factors in Breast Cancer. EcancerMedicalscience, 11, Article 175. https://doi.org/10.3332/ecancer.2017.715
[48]
IAEA (Agence Internationale de l’énergie Atomique) (2008) Section Médecine Nucléaire: Critères pour la palliation des métastases osseuses—Applications clinique.
[49]
Yamashiro, H., Takada, M., Nakatani, E., Imai, S., et al. (2014) Prevalence and Risk Factors of Bone Metastasis and Skeletal Related Events in Patients with Primary Breast Cancer in Japan. International Journal of Clinical Oncology, 19, 852-862. https://doi.org/10.1007/s10147-013-0643-5
[50]
Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2017) Adjuvant Bisphosphonate Treatment in Early Breast Cancer: Meta-Analyses of Individual Patient Data from Randomised Trials. The Lancet, 386, 1353-1361.
[51]
Liede, A., Jerzak, K.J., Hernandez, R.K., Wade, S.W., et al. (2016) The Incidence of Bone Metastasis after Early-Stage Breast Cancer in Canada. Breast Cancer Research and Treatment, 156, 587-595. https://doi.org/10.1007/s10549-016-3782-3
[52]
Diessner, J., Wischnewsky, M., Stüber, T., Stein, R., et al. (2016) Evaluation of Clinical Parameters Influencing the Development of Bone Metastasis in Breast Cancer. BMC Cancer, 16, Article No. 307. https://doi.org/10.1186/s12885-016-2345-7
[53]
Tafreshi, N.K., Kumar, V., Morse, D.L. and Gatenby, R.A. (2010) Molecular and Functional Imaging of Breast Cancer. Cancer Control, 17, 143-155. https://doi.org/10.1177/107327481001700302
[54]
Koizumi, M. and Koyama, M. (2019) Comparison between Single Photon Emissions Computed Tomography with Computed Tomography and Planar Scintigraphy in Sentinel Node Biopsy in Breast Cancer Patients. Annals of Nuclear Medicine, 33, 160-168. https://doi.org/10.1007/s12149-018-1319-z
