Increased Breast Density Correlates with the Proliferation-Seeking Radiotracer ^99mTc(V)-DMSA Uptake in Florid Epithelial Hyperplasia and in Mixed Ductal Carcinoma in Situ with Invasive Ductal Carcinoma but Not in Pure Invasive Ductal Carcinoma or in Mild Epithelial Hyperplasia

Abstract

The purpose of this study was to assess the relationship of mammographic breast density (BD) and cell proliferation/focal adhesion kinase activation-seeking radiotracer technetium 99m pentavalent dimercaptosuccinic acid (99mTc(V)-DMSA) uptake in women with different breast histologies, that is, mild epithelial hyperplasia (MEH), florid epithelial hyperplasia (FEH), mixed ductal carcinoma in situ with invasive ductal carcinoma (DCIS + IDC), and pure IDC. Fifty-five women with histologically confirmed mammary pathologies were submitted preoperatively to mammography and 99mTc(V)-DMSA scintimammography. The percentage and intensity of 99mTc(V)-DMSA uptake and the percentage of BD were calculated by computer-assisted methods and compared (t-test) between the breast pathologies. In breasts with increased BD, FEH and DCIS + IDC were found. On the contrary, pure IDC and MEH were identified in breasts with significantly lower BD values. In breasts with increased 99mTc(V)-DMSA area and intensity of uptake, FEH was the main lesion found compared to all other histologies. Linear regression analysis between BD and 99mTc(V)-DMSA uptake area and intensity revealed significant coefficients of correlation (r = .689, p < .001 and r = .582, p < .001, respectively). Increased BD correlates with the presence of FEH and mixed DCIS + IDC but not with pure IDC or MEH. Its close relationship to 99mTc(V)-DMSA, which also showed an affinity to FEH, indicates that stromal microenvironment may constitute a specific substrate leading to progression to different subtypes of cancerous lesions originating from different pathways.

The diagnostic sensitivity of dynamic contrast-enhanced magnetic resonance imaging and breast-specific gamma imaging in women with calcified and non-calcified DCIS

“…The MRI sensitivity is similar to that reported previously (7,14,15). The BSGI sensitivity for the detection of DCIS (68.6%) was lower than those reported elsewhere (89% and 75%, respectively (14,16)). Notably, previous studies did not show statistical significance (10,14).…”

Dimercaptosuccinic acid: A multifunctional cost effective agent for imaging and therapy

“…Tc-99m (V) DMSA uptake in breast cancer and Ki-67 expression suggests Tc-99m (V) DMSA as a surrogate marker of cell proliferation. [ 71 ] Tc-99m (V) DMSA correlates with tumor aggressiveness and provides important information regarding the correlation of tumor subtype with breast density[ 72 ] [ Table 4 ].…”