Metástases ósseas no câncer de mama - revisão dos achados nos exames diagnósticos por imagem.
DOI:
https://doi.org/10.69849/01gckv05Palavras-chave:
metástase, metástase óssea, câncer de mama, tomografia computadorizadaResumo
O câncer de mama é a neoplasia maligna mais frequente nas mulheres mundialmente, depois do de pele não melanoma. Nas últimas décadas, avanços no diagnóstico precoce e no tratamento conduziram a uma maior taxa de sobrevida nesse panorama. No entanto, uma expressiva parcela de pacientes com neoplasia avançada apresentará doença metastática à distância, principalmente em sítios como pulmão, fígado, cérebro e ossos. As metástases ósseas irão representar cerca de 70% das metástases encontradas nesses casos. Dessa forma, os exames diagnósticos por imagem, como a radiografia, tomografia computadorizada e ressonância magnética, desempenham um papel importante no rastreio e detecção dessas metástases. Assim como, recentemente, a tomografia por emissão de pósitrons acoplada à tomografia computadorizada ou à ressonância magnética, que são exames que avaliam o metabolismo, e são utilizados na investigação de metástases, inclusive ósseas, por sua maior acurácia. Portanto, esse trabalho objetiva, por meio do estudo da literatura, realizar uma análise crítica das principais características dos exames por imagem utilizados para o rastreio de metástases ósseas no câncer de mama e a revisão dos achados nos exames diagnósticos por imagem.
Referências
Instituto Nacional de Câncer, INCA, 2023.
Tahara, R.K., Brewer, T.M., Theriault, R.L., Ueno, N.T. (2019). Bone Metastasis of Breast Cancer. In: Ahmad, A. (eds) Breast Cancer Metastasis and Drug Resistance. Advances in Experimental Medicine and Biology, vol 1152. Springer, Cham. https://doi.org/10.1007/978-3-030-20301-6_7).
Ulmert D, Solnes L, Thorek DLj. Contemporary approaches for imaging skeletal metastasis. Bone Res. 2015 Jul 14;3:15024. doi: 10.1038/boneres.2015.24. PMID: 26273541; PMCID: PMC4502405.
Huynh PT, Lemeshko SV, Mahoney MC, Newell MS, Bailey L, Barke LD, D'Orsi C, Harvey JA, Hayes MK, Jokich PM, Lee SJ, Lehman CD, Mainiero MB, Mankoff DA, Patel SB, Reynolds HE, Sutherland ML, Haffty BG. ACR Appropriateness Criteria® Stage I Breast Carcinoma. J Am Coll Radiol. 2016 Nov;13(11S):e53-e57. doi: 10.1016/j.jacr.2016.09.024. PMID: 27814824.
Ha JY, Jeon KN, Bae K, Choi BH. Effect of Bone Reading CT software on radiologist performance in detecting bone metastases from breast cancer. Br J Radiol. 2017 Apr;90(1072):20160809. doi: 10.1259/bjr.20160809. Epub 2017 Mar 3. PMID: 28256905; PMCID: PMC5605069.
Sanches PG, Peters S, Rossin R, Kaijzel EL, Que I, Löwik CW, Grüll H. Bone metastasis imaging with SPECT/CT/MRI: a preclinical toolbox for therapy studies. Bone. 2015 Jun;75:62-71. doi: 10.1016/j.bone.2015.02.002. Epub 2015 Feb 10. PMID: 25680341.
Park S, Yoon JK, Jin Lee S, Kang SY, Yim H, An YS. Prognostic utility of FDG PET/CT and bone scintigraphy in breast cancer patients with bone-only metastasis. Medicine (Baltimore). 2017 Dec;96(50):e8985. doi: 10.1097/MD.0000000000008985. PMID: 29390293; PMCID: PMC5815705.
Von Moos R, Body JJ, Egerdie B, Stopeck A, Brown J, Fallowfield L, Patrick DL, Cleeland C, Damyanov D, Palazzo FS, Marx G, Zhou Y, Braun A, Balakumaran A, Qian Y. Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases. Support Care Cancer. 2016 Mar;24(3):1327-37. doi: 10.1007/s00520-015-2908-1. Epub 2015 Sep 2. PMID: 26329397; PMCID: PMC4729787.
Roberts CC, Daffner RH, Weissman BN, Bancroft L, Bennett DL, Blebea JS, Bruno MA, Fries IB, Germano IM, Holly L, Jacobson JA, Luchs JS, Morrison WB, Olson JJ, Payne WK, Resnik CS, Schweitzer ME, Seeger LL, Taljanovic M, Wise JN, Lutz ST. ACR appropriateness criteria on metastatic bone disease. J Am Coll Radiol. 2010 Jun;7(6):400-9. doi: 10.1016/j.jacr.2010.02.015. Erratum in: J Am Coll Radiol. 2010 Sep;7(9):e1. PMID: 20522392.
Li X, An C, Zhang W. Is it sufficient to evaluate metastatic bone involvement in breast cancer using SPECT/CT? A new approach of SPECT/CT-guided targeted bone marrow biopsy. BMC Cancer. 2022 Jun 4;22(1):614. doi: 10.1186/s12885-022-09702-1. PMID: 35659208; PMCID: PMC9167511.
Ha JY, Jeon KN, Bae K, Choi BH. Effect of Bone Reading CT software on radiologist performance in detecting bone metastases from breast cancer. Br J Radiol. 2017 Apr;90(1072):20160809. doi: 10.1259/bjr.20160809. Epub 2017 Mar 3. PMID: 28256905; PMCID: PMC5605069.
McDonald ES, Clark AS, Tchou J, Zhang P, Freedman GM. Clinical Diagnosis and Management of Breast Cancer. J Nucl Med 2016;57 Suppl1:9S-16S. https://doi.org/10.2967/jnumed.115.157834.
Hong JH, Goo JM, Moon HG, Chang JM, Lee JH, Park CM. Usefulness of staging chest-CT in patients with operable breast cancer. PLoS ONE 2021;16(2):e0246563. https://doi.org/10.1371/journal.pone.0246563.
Onega T, Beaber EF, Sprague BL, Barlow WE, Haas JS, Tosteson AN, D Schnall M, Armstrong K, Schapira MM, Geller B, Weaver DL, Conant EF. Breast cancer screening in an era of personalized regimens: a conceptual model and National Cancer Institute initiative for risk-based and preference-based approaches at a population level. Cancer. 2014 Oct 1;120(19):2955-64. doi: 10.1002/cncr.28771. Epub 2014 May 15. PMID: 24830599; PMCID: PMC4342235.
Chikarmane SA, Tirumani SH, Howard SA, Jagannathan JP, DiPiro PJ. Metastatic patterns of breast cancer subtypes: what radiologists should know in the era of personalized cancer medicine. Clin Radiol. 2015 Jan;70(1):1-10. doi: 10.1016/j.crad.2014.08.015. Epub 2014 Oct 7. PMID: 25300558.
Tan, P H, Ellis, I, Allison, K, Brogi, E, Fox, S B, Lakhani, S, Lazar, A J, Morris, E A, Sahin, A, Salgado, R, Sapino, A, Sasano, H, Schnitt, S, Sotiriou, C, van Diest, P, White, V A, Lokuhetty, D, Cree, I A & for the WHO Classification of Tumours Editorial Board. (2020) Histopathology 77, 181–185. https://doi.org/10.1111/his.14091 The 2019 World Health Organization classification of tumours of the breast.
Bhaludin BN, Tunariu N, Koh DM, Messiou C, Okines AF, McGrath SE, Ring AE, Parton MM, Sharma B, Gagliardi T, Allen SD, Pope R, Johnston SRD, Downey K. A review on the added value of whole-body MRI in metastatic lobular breast cancer. Eur Radiol. 2022 Sep;32(9):6514-6525. doi: 10.1007/s00330-022-08714-6. Epub 2022 Apr 6. PMID: 35384456.
Hogan MP, Goldman DA, Dashevsky B, Riedl CC, Gönen M, Osborne JR, Jochelson M, Hudis C, Morrow M, Ulaner GA. Comparison of 18F-FDG PET/CT for Systemic Staging of Newly Diagnosed Invasive Lobular Carcinoma Versus Invasive Ductal Carcinoma. J Nucl Med. 2015 Nov;56(11):1674-80. doi: 10.2967/jnumed.115.161455. Epub 2015 Aug 20. PMID: 26294295; PMCID: PMC4869690.
Groheux D, Giacchetti S, Espié M, Vercellino L, Hamy AS, Delord M, Berenger N, Toubert ME, Misset JL, Hindié E. The yield of 18F-FDG PET/CT in patients with clinical stage IIA, IIB, or IIIA breast cancer: a prospective study. J Nucl Med. 2011 Oct;52(10):1526-34. doi: 10.2967/jnumed.111.093864. Epub 2011 Aug 30. PMID: 21880576.
Dashevsky BZ, Goldman DA, Parsons M, Gönen M, Corben AD, Jochelson MS, Hudis CA, Morrow M, Ulaner GA. Appearance of untreated bone metastases from breast cancer on FDG PET/CT: importance of histologic subtype. Eur J Nucl Med Mol Imaging. 2015 Oct;42(11):1666-1673. doi: 10.1007/s00259-015-3080-z. Epub 2015 May 14. PMID: 25971426; PMCID: PMC4558334.
INCA dados_e_numeros_site_cancer_mama_setembro2022
Cardoso F, Kyriakides S, Ohno S, Penault-Llorca F, Poortmans P, Rubio IT, et al. Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2019 Aug;30(8):1194–220.
Amin MB, Edge S, Greene F, Byrd DR, Brookland RK, Washington MK, et al., editors. AJCC Cancer Staging Manual. 8th ed. Springer International Available from: https:// www.springer.com/gp/book/9783319406176.
Instituto Nacional de Câncer (Brasil). Parâmetros técnicos para detecção precoce do câncer de mama. / Instituto Nacional de Câncer. – Rio de Janeiro : INCA, 2022.
Pace LE, Keating NL. A systematic assessment of benefits and risks to guide breast cancer screening decisions. JAMA. 2014;311:1327–1335.
Pesapane F, Downey K, Rotili A, Cassano E, Koh DM. Imaging diagnosis of metastatic breast cancer. Insights Imaging. 2020 Jun 16;11(1):79. doi: 10.1186/s13244-020-00885-4. PMID: 32548731; PMCID: PMC7297923.
Lim CH, Moon SH, Cho YS, Im YH, Choe YS, Kim BT, Lee KH. Relation between primary tumor FDG avidity and site of first distant metastasis in patients with breast cancer. Medicine (Baltimore). 2016 Aug;95(32):e4266. doi: 10.1097/MD.0000000000004266. Erratum in: Medicine (Baltimore). 2016 Oct 07;95(40):e503a. PMID: 27512840; PMCID: PMC4985295.
Chen YC, Sosnoski DM, Mastro AM. Breast cancer metastasis to the bone: mechanisms of bone loss. Breast Cancer Res. 2010;12(6):215. doi: 10.1186/bcr2781. Epub 2010 Dec 16. PMID: 21176175; PMCID: PMC3046443.
He F, Chiou AE, Loh HC, Lynch M, Seo BR, Song YH, Lee MJ, Hoerth R, Bortel EL, Willie BM, Duda GN, Estroff LA, Masic A, Wagermaier W, Fratzl P, Fischbach C. Multiscale characterization of the mineral phase at skeletal sites of breast cancer metastasis. Proc Natl Acad Sci U S A. 2017 Oct 3;114(40):10542-10547. doi: 10.1073/pnas.1708161114. Epub 2017 Sep 18. PMID: 28923958;PMCID: PMC5635895.
Ellmann S, Seyler L, Evers J, Heinen H, Bozec A, Prante O, Kuwert T, Uder M, Bäuerle T. Prediction of early metastatic disease in experimental breast cancer bone metastasis by combining PET/CT and MRI parameters to a Model-Averaged Neural Network. Bone. 2019 Mar;120:254-261. doi: 10.1016/j.bone.2018.11.008. Epub 2018 Nov 13. PMID: 30445200.
Al-Muqbel KM. Bone Marrow Metastasis Is an Early Stage of Bone Metastasis in Breast Cancer Detected Clinically by F18-FDG-PET/CT Imaging. Biomed Res Int. 2017;2017:9852632. doi: 10.1155/2017/9852632. Epub 2017 Aug 13. PMID: 28884133; PMCID: PMC5572575.
Seeley EH, Wilson KJ, Yankeelov TE, Johnson RW, Gore JC, Caprioli RM, Matrisian LM, Sterling JA. Co-registration of multi-modality imaging allows for comprehensive analysis of tumor-induced bone disease. Bone. 2014 Apr;61:208-16. doi: 10.1016/j.bone.2014.01.017. Epub 2014 Jan 30. PMID: 24487126; PMCID: PMC4005328.
Evangelista L, Panunzio A, Polverosi R, Ferretti A, Chondrogiannis S, Pomerri F, Rubello D, Muzzio PC. Early bone marrow metastasis detection: the additional value of FDG-PET/CT vs. CT imaging. Biomed Pharmacother. 2012 Sep;66(6):448-53. doi: 10.1016/j.biopha.2012.06.004. Epub 2012 Jul 3. PMID: 22902054.
Dadgar H, Norouzbeigi N, Jokar N, Zareizadeh J, Gholamrezanezhad A, Ahmadzadehfar H, Abbaszadeh M, Assadi M. Comparison of 18 F-NaF Imaging, 99m Tc-MDP Scintigraphy, and 18 F-FDG for Detecting Bone Metastases. World J Nucl Med. 2022 Apr 30;21(1):1-8. doi: 10.1055/s-0042-1748154. PMID: 35502272; PMCID:PMC9056122.
Orcajo-Rincon J, Muñoz-Langa J, Sepúlveda-Sánchez JM, Fernández-Pérez GC, Martínez M, Noriega-Álvarez E, Sanz-Viedma S, Vilanova JC, Luna A. Review of imaging techniques for evaluating morphological and functional responses to the treatment of bone metastases in prostate and breast cancer. Clin Transl Oncol. 2022 Jul;24(7):1290-1310. doi: 10.1007/s12094-022-02784-0. Epub 2022 Feb 13. PMID: 35152355; PMCID: PMC9192443.
Amin MB, Edge S, Greene F, Byrd DR, Brookland RK, Washington MK, et al., editors. AJCC Cancer Staging Manual. 8th ed. Springer International Available from: https:// www.springer.com/gp/book/9783319406176.
Huynh, P. T., Lemeshko, S. V., Mahoney, M. C., Newell, M. S., Bailey, L., Barke, L. D., … Haffty, B. G. (2016). ACR Appropriateness Criteria® Stage I Breast Carcinoma. Journal of the American College of Radiology, 13(11), e53–e57. doi:10.1016/j.jacr.2016.09.024).
Ikeda T, Kitajima K, Tsuchitani T, Takahashi Y, Hama Y, Kotura N. Effectiveness of quantitative bone SPECT/CT for bone metastasis diagnosis. Hell J Nucl Med. 2022 Sep-Dec;25(3):253-259. doi: 10.1967/s002449912513. Epub 2022 Dec 14. PMID: 36507881.
Hansen JA, Naghavi-Behzad M, Gerke O, Baun C, Falch K, Duvnjak S, Alavi A, Høilund-Carlsen PF, Hildebrandt MG. Diagnosis of bone metastases in breast cancer: Lesion-based sensitivity of dual-time-point FDG-PET/CT compared to low-dose CT and bone scintigraphy. PLoS One. 2021 Nov 18;16(11):e0260066. doi: 10.1371/journal.pone.0260066. PMID: 34793550; PMCID: PMC8601566.
Isaac A, Dalili D, Dalili D, Weber MA. State-of-the-art imaging for diagnosis of metastatic bone disease. Radiologe. 2020 Nov;60(Suppl 1):1-16. doi: 10.1007/s00117-020-00666-6. PMID: 32211916; PMCID: PMC7686212.
Pujara AC, Raad RA, Ponzo F, Wassong C, Babb JS, Moy L, Melsaether AN. Standardized Uptake Values from PET/MRI in Metastatic Breast Cancer: An Organ-based Comparison With PET/CT. Breast J. 2016 May;22(3):264-73. doi: 10.1111/tbj.12569. Epub 2016 Feb 4. PMID: 26843433; PMCID: PMC4915070.
Vadi SK, Mittal BR, Sood A, Singh G, Bal A, Parihar AS, Bhattacharya A, Basher RK, Kapoor R. Diagnostic and prognostic value of 18F-FDG PET/CT imaging in suspected recurrence of male breast cancer. Nucl Med Commun. 2019 Jan;40(1):63-72. doi: 10.1097/MNM.0000000000000928. PMID: 30312217; PMCID: PMC6282661.
From Solid Tumors. Acad Radiol. 2018 Nov;25(11):1405-1414. doi: 10.1016/j.acra.2018.02.010. Epub 2018 Apr 4. PMID: 29627288; PMCID: PMC6170723).
Hamaoka T, Madewell JE, Podoloff DA, Hortobagyi GN, Ueno NT. Bone imaging in metastatic breast cancer. J Clin Oncol. 2004 Jul 15;22(14):2942-53. doi: 10.1200/JCO.2004.08.181. PMID: 15254062.
Hong S, Li J, Wang S. 18FDG PET-CT for diagnosis of distant metastases in breast cancer patients. A meta-analysis. Surg Oncol. 2013 Jun;22(2):139-43. doi: 10.1016/j.suronc.2013.03.001. Epub 2013 Apr 5. PMID: 23566435.
Paydary K, Seraj SM, Zadeh MZ, Emamzadehfard S, Shamchi SP, Gholami S, Werner TJ, Alavi A. The Evolving Role of FDG-PET/CT in the Diagnosis, Staging, and Treatment of Breast Cancer. Mol Imaging Biol. 2019 Feb;21(1):1-10. doi: 10.1007/s11307-018-1181-3. PMID: 29516387.
Macdonald S, Oncology R, General M. Breast Cancer - NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) - NCCN Evid BlocksTM. National Comprehensive Cancer Network (NCCN); 2020.
Ko H, Baghdadi Y, Love C, Sparano JA. Clinical Utility of 18F-FDG PET/CT in Staging Localized Breast Cancer Before Initiating Preoperative Systemic Therapy. J Natl Compr Canc Netw. 2020 Sep;18(9):1240-1246. doi: 10.6004/jnccn.2020.7592. PMID: 32886897.
Bénard F, Harsini S, Wilson D, Zukotynski K, Abikhzer G, Turcotte E, Cossette M, Metser U, Romsa J, Martin M, Mar C, Saad F, Soucy JP, Eigl BJ, Black P, Krauze A, Burrell S, Nichol A, Tardif JC. Intra-individual comparison of 18F-sodium fluoride PET-CT and 99mTc bone scintigraphy with SPECT in patients with prostate cancer or breast cancer at high risk for skeletal metastases (MITNEC-A1): a multicentre, phase 3 trial. Lancet Oncol. 2022 Dec;23(12):1499-1507. doi: 10.1016/S1470-2045(22)00642-8. Epub 2022 Nov 4. PMID: 36343655.
Ming Y, Wu N, Qian T, Li X, Wan DQ, Li C, Li Y, Wu Z, Wang X, Liu J, Wu N. Progress and Future Trends in PET/CT and PET/MRI Molecular Imaging Approaches for Breast Cancer. Front Oncol. 2020 Aug 12;10:1301. doi: 10.3389/fonc.2020.01301. PMID: 32903496; PMCID: PMC7435066.
Jacobs MA, Macura KJ, Zaheer A, Antonarakis ES, Stearns V, Wolff AC, Feiweier T, Kamel IR, Wahl RL, Pan L. Multiparametric Whole-body MRI with Diffusion-weighted Imaging and ADC Mapping for the Identification of Visceral and Osseous Metastases From Solid Tumors. Acad Radiol. 2018 Nov;25(11):1405-1414. doi: 10.1016/j.acra.2018.02.010. Epub 2018 Apr 4. PMID: 29627288; PMCID: PMC6170723.
Botsikas D, Bagetakos I, Picarra M, Da Cunha Afonso Barisits AC, Boudabbous S, Montet X, Lam GT, Mainta I, Kalovidouri A, Becker M. What is the diagnostic performance of 18-FDG-PET/MR compared to PET/CT for the N- and M- staging of breast cancer? Eur Radiol. 2019 Apr;29(4):1787-1798. doi: 10.1007/s00330-018-5720-8. Epub 2018 Sep 28. PMID: 30267154.
Niikura N, Hashimoto J, Kazama T, Koizumi J, Ogiya R, Terao M, Oshitanai R, Morioka T, Tsuda B, Okamura T, Saito Y, Iwaisako K, Iwamoto T, Hayashi N, Imai Y, Tokuda Y. Diagnostic performance of (18)F-fluorodeoxyglucose PET/CT and bone scintigraphy in breast cancer patients with suspected bone metastasis. Breast Cancer. 2016 Jul;23(4):662-7. doi: 10.1007/s12282-015-0621-z. Epub 2015 Jun 3. PMID: 26037335.
Morris PG, Ulaner GA, Eaton A, Fazio M, Jhaveri K, Patil S, Evangelista L, Park JY, Serna-Tamayo C, Howard J, Larson S, Hudis CA, McArthur HL, Jochelson MS. Standardized uptake value by positron emission tomography/computed tomography as a prognostic variable in metastatic breast cancer. Cancer. 2012 Nov 15;118(22):5454-62. doi: 10.1002/cncr.27579. Epub 2012 Apr 19. PMID: 22517371.
Van Es SC, Velleman T, Elias SG, Bensch F, Brouwers AH, Glaudemans AWJM, Kwee TC, Iersel MW, Maduro JH, Oosting SF, de Vries EGE, Schröder CP. Assessment of Bone Lesions with 18F-FDG PET Compared with 99mTc Bone Scintigraphy Leads to Clinically Relevant Differences in Metastatic Breast Cancer Management. J Nucl Med. 2021 Feb;62(2):177-183. doi: 10.2967/jnumed.120.244640. Epub 2020 Aug 17. PMID: 32817140.
Jung NY, Yoo IR, Kang BJ, Kim SH, Chae BJ, Seo YY. Clinical significance of FDG-PET/CT at the postoperative surveillance in the breast cancer patients. Breast Cancer. 2016 Jan;23(1):141-148. doi: 10.1007/s12282-014-0542-2. Epub 2014 May 29. PMID: 24872087
De Giorgi U, Valero V, Rohren E, Mego M, Doyle GV, Miller MC, Ueno NT, Handy BC, Reuben JM, Macapinlac HA, Hortobagyi GN, Cristofanilli M. Circulating tumor cells and bone metastases as detected by FDG-PET/CT in patients with metastatic breast cancer. Ann Oncol. 2010 Jan;21(1):33-9. doi: 10.1093/annonc/mdp262. Epub 2009 Jul 14. PMID: 19602564.
Kosmin M, Makris A, Joshi PV, Ah-See ML, Woolf D, Padhani AR. The addition of whole-body magnetic resonance imaging to body computerised tomography alters treatment decisions in patients with metastatic breast cancer. Eur J Cancer. 2017 May;77:109-116. doi: 10.1016/j.ejca.2017.03.001. Epub 2017 Apr 5. PMID: 28390297.
Llewelyn R, Knipe H, Bell D, et al. Response evaluation criteria in solid tumors.Reference article, Radiopaedia.org https://doi.org/10.53347/rID-19147.
Bashir U, Knipe H, Rozmiarek J, et al. RECIST 1.1: comparison with RECIST 1.0. Reference article, Radiopaedia.org https://doi.org/10.53347/rID-19590.
Nikolaev A, Moore C, Sharma R, et al. Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST). Reference article, Radiopaedia.org https://doi.org/10.53347/rID-57911.
Mann RM, Cho N, Moy L. Breast MRI: State of the Art. Radiology. 2019 Sep;292(3):520-536. doi: 10.1148/radiol.2019182947. Epub 2019 Jul 30. PMID: 31361209.
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