Three Nuclear Medicine diagnostic procedures and breast cancer mortality in women. A population-analysis in Taiwan based upon National Health Insurance database.

OBJECTIVE: To investigate the correlation between the utilization of nuclear medicine diagnostic procedures and the mortality of women with breast cancer. SUBJECTS AND METHODS: Based on the National Health Insurance Research Database (NHIRD), we studied female breast cancer patients in 2012 who underwent whole-body bone scan, lymphoscintigraphy, or fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for possibly managing breast cancer metastases. The mortality of breast cancer was then followed up in 2017. Multiple linear regression analysis was applied to analyze the correlation between the use of any of these three nuclear medicine procedures and the mortality of breast cancer.
RESULTS: For patients with early-stage breast cancer, single lymphoscintigraphy was the most frequently performed nuclear medicine procedure, accounting for 36.4% of all three nuclear medicine procedures. For patients with late-stage breast cancer, single whole-body bone scan was the most frequently performed nuclear medicine procedure, accounting for 67.2% of all three nuclear medicine procedures. Mortality of breast cancer significantly increased with the prevalence of late-stage breast cancer (b=2.87, P=0.001) and significantly decreased in cases in which whole-body bone scan was used (b=-4.28, P=0.003).
CONCLUSION: The mortality of women with late-stage breast cancer was negatively related to the utilization of whole-body bone scan but not to the utilization of lymphoscintigraphy or the 18F-FDG PET/CT scan. In women with early-stage breast cancer, no significant correlation existed between breast cancer mortality and the utilization of the above three nuclear medicine procedures.