Abstract
Breast cancer is the most common malignancy in women throughout the world. Metastatic dissemination to vital organs is the leading cause of breast cancer-related deaths. The treatment of metastases is mainly based on the primary tumor characteristics. However, breast cancer metastases exhibit high heterogeneity leading to different prognosis and therapeutic responses. Getting access to phenotype of metastases would allow better management of patients. The advent of theranostics in nuclear medicine has opened new opportunities for the diagnosis and treatment of cancer patients. The aim of this review is to provide an overview of current knowledge and future directions in nuclear medicine for therapeutic management of metastatic breast cancer patients.
Highlights
Breast cancer is the most common female malignancy, accounting for more than 30% of all malignant tumors in women [1]
The prognosis of breast cancer patients is highly dependent of the breast cancer genotype; as patients with HER2 or basal-like cancers have worse prognoses compared to patients with luminal A or luminal B breast cancers [5]
The first highlight of this phenomenon comes from the analysis of scattered cells isolated from the bone marrow of patients with non-metastatic breast cancer; the presence of isolated tumor cells in the marrow increases the risk of relapse [20,21,22]
Summary
Breast cancer is the most common female malignancy, accounting for more than 30% of all malignant tumors in women [1]. Breast cancer is a complex and highly heterogeneous disease consisting of various subtypes. It is classified into human epidermal growth receptor 2 (HER-2), luminal A, luminal B and basal-like, based on histological and molecular features [3,4]. Breast cancer prognosis is highly dependent of the disease stage at the time of diagnosis. 20% to 45% of metastases exhibit different phenotypes as compared to the primary tumor [8]. Getting access to metastases phenotype would define a more accurate treatment, depending on the molecular characteristics of these lesions. In addition to accurate phenotype acquisitions, nuclear medicine allows promising therapeutic opportunities to treat a large panel of cancers including breast [9]
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