Abstract
Neoadjuvant chemotherapy (NCT) has become a standard therapeutic method for focal advanced breast carcinoma. The multidrug resistance (MDR) of tumors is one of the main causes of chemotherapy failure in breast cancer. MDR development involves the transmembrane P-glycoprotein (P-gp) encoded by the MDR gene MDR1. 99Tcm-methoxyisobutylisonitrile (MIBI) is a radiotracer for scintigraphy of tumors. MIBI is also a transport substrate for P-gp and has been used in assessing P-gp-mediated MDR in a variety of tumors. The nuclear medicine community in the USA has suggested the use of 99Tcm-MIBI scintigraphy as a noninvasive method in in vivo imaging of MDR. Studies have shown that early imaging of 99Tcm-MIBI reveals the accumulative quantity of MIBI in breast tumors, and correlated with malignant extent of tumor. Thus, early imaging through 99Tcm-MIBI can be conducted to evaluate the curative effect of NCT in breast cancer. Delayed imaging reveals the washout rates of MIBI from breast tumors, which is correlated with P-gp expression and MDR. Thus, delayed 99Tcm-MIBI may provide important information on P-gp-mediated MDR and may predict chemotherapy sensitivity. Key words: Breast neoplasms; Technetium Tc 99m sestamibi; Multidrug resistance-associated proteins; P-glycoprotein; Neoadjuvant chemotherapy; Evaluating curative effect
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