Primary Lymphomas of the Breast Detected by Ga-67 Scintigraphy

Abstract

Three patients with primary breast lymphoma were reported. All patients had rapidly growing breast masses and these masses showed nonspecific findings in mammography and on ultrasound. They resembled phyllodes tumor or invasive ductal carcinomas. Ga-67 scintigraphy showed intense accumulation was seen in all of the lymphomas. In one patient, a breast carcinoma was detected in the contralateral breast which did not show Ga-67 accumulation. In the other two patients, axillary involvement was also detected. Scintigraphy was helpful to confirm the diagnosis of breast lymphoma.

Gallium avid breast carcinoma

“…Conversely, low‐grade lymphoma demonstrates greater avidity for Tl‐201 and is less likely to take up Ga‐67 8,9 . Approximately 50–70% of low‐grade lymphoma (small lymphocytic and small cleaved types) have marrow involvement, which may be extensive 21 .…”

“…This case therefore illustrates a rare example of primary breast carcinoma that accumulates Ga‐67 but not Tl‐201. Only 25% of breast carcinomas are reported in the published research to accumulate Ga‐67, whereas 96% of them are Tl‐201 avid 4,8 . As most breast cancers are not gallium avid, gallium scans are not routinely performed in patients with suspected breast cancer 18 .…”

“…20,21 Conversely, low-grade lymphoma demonstrates greater avidity for Tl-201 and is less likely to take up Ga-67. 8,9 Approximately 50-70% of low-grade lymphoma (small lymphocytic and small cleaved types) have marrow involvement, which may be extensive. 21 This case therefore illustrates a rare example of primary breast carcinoma that accumulates Ga-67 but not Tl-201.…”

“…Only 25% of breast carcinomas are reported in the published research to accumulate Ga-67, whereas 96% of them are Tl-201 avid. 4,8 As most breast cancers are not gallium avid, gallium scans are not routinely performed in patients with suspected breast cancer. 18 Furthermore, it is unusual for breast carcinoma to present clinically with pancytopenia related to marrow failure, highlighting the aggressive nature of the tumour.…”

“…In contrast to Tl-201 and TC-sestamibi, the sensitivity of GA-67 in primary breast carcinoma is as low as 25%. 8 Therefore, in general, primary breast carcinomas are considered thallium and sestamibi avid, but do not accumulate gallium.…”