Breast Cancer – Diagnostics – Localization of metastases
Scanning for metastases, which is always performed when cancer is detected, is very important for planning further treatment. The lungs and chest are usually X-rayed, scintigraphy (nuclear medicine examination) of the bones is carried out and the liver is examined using ultrasound.
Methods to locate metastases:
Lymphadenectomy may be required to determine if and how many axillary lymph nodes are affected. Today, images of the so-called sentinel lymph nodes are taken using mildly radioactive markers (radioisotopes) and a biopsy of these nodes is performed for this purpose. If the sentinel lymph nodes are not affected, all the other lymph nodes will be spared. Otherwise, up to 10 nodes will have to be removed.
- Nuclear medical examinations are often necessary to scan for metastases or the spread of the cancer. The very small amounts of radioactive substance used to detect metastases are usually well tolerated by the majority of patients. The human body is able to break down or eliminate these radiopharmaceuticals quickly. The exposure to radiation is low.
- Scintigraphy is the standard examination. It is performed to identify tumor foci using injected radioisotopes, which accumulate more quickly in a tumor than in healthy tissue. This method provides important information for planning further treatment. It is also used to control and monitor the progression of the disease and treatment, as well as provide information about if and how metastases are responding to a particular treatment.
- Single Photon Emission Computed Tomography (SPECT), as a three-dimensional scintigraphy procedure, provides information about metabolic activity in the breast tissue. However, it produces an insufficient image of the shape (morphology) of the tissue. For this purpose, it is possible to combine it with a CT scan, which will provide additional anatomical information.
- Positron Emission Tomography (PET) may detect even very small tumors and metastases. It uses radioisotopes to visualize metabolic activities inside the tissue. It therefore allows identification of small tumors and metastasis earlier than anatomy-based imaging tests. However, PET is not a standard procedure. Just as with SPECT, PET can be combined with a CT scan (PET-CT) as well.