E-ISSN 2305-1620 | ISSN 2221-0288
 

Original Article

Online Publishing Date:
22 / 01 / 2021

 


Radioactive iodine uptake in the breast tissue of nulliparous adolescent girls and young women

Andrew C. Sher, Nadia F. Mahmood, Robert C. Orth, Shireen E. Hayatghaibi, Marla B. K. Sammer, Victor J. Seghers.


Abstract
Background: Pediatric thyroid cancer is the second most common cancer among girls aged 15-19 years, with lymph node involvement and pulmonary metastasis more common than in adults. In interpreting whole-body I-123 scintigraphy, differentiation between physiologic breast uptake and rib or lung metastasis can be challenging. While radioiodine uptake in lactating breasts has been recognized for over 65 years, breast uptake in nulliparous girls and young women has not previously been documented.
Methods: Female nulliparous patients <21 years with primary thyroid cancer requiring whole-body I-123 scintigraphy with anterior and lateral planar images from 25 September 2014 to 22 March 2017 were eligible for inclusion. Four physicians with training in nuclear radiology evaluated the anterior and lateral spot views for the presence of breast activity on a 5-point Likert scale. Fleiss’ Kappa and Monte Carlo simulations were used to calculate mean Likert values, reader agreement, and 95% CIs.
Results: For this study, 27 patients met the inclusion criteria (mean age=15.9±2.3 years). Breast activity was present in 20/27 (74%) patients. Mean Likert scores and agreement were: present on frontal images = 3.9 ± 1.2, κ = 0.74 (0.61-0.83); limited to the lower thorax on frontal images= 4.0 ± 1.2, κ=0.77 (0.63-0.88); present on lateral images = 4.2 ± 1.2, κ = 0.85 (0.71-0.93); and present given all projections= 4.2 ± 1.3, κ = 0.85 (0.71-0.94).
Conclusion: Breast activity on whole-body I-123 scintigraphy is present in the majority of nulliparous young women. However, any suspicious uptake in the chest must be further characterized using lateral views of the chest to differentiate between physiological breast uptake and pathological uptake in ribs or lungs. We recommend routine lateral images of pediatric patients undergoing radioactive iodine scintigraphy for evaluation of thyroid cancer.

Key words: Breast, lung, metastases, radioiodine uptake, I-123 scintigraphy, thyroid cancer, pediatric


 
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How to Cite this Article
Pubmed Style

Sher AC, Mahmood NF, Orth RC, Hayatghaibi SE, Sammer MBK, Seghers VJ. Radioactive iodine uptake in the breast tissue of nulliparous adolescent girls and young women. Pak J Nucl Med. 2021; 11(1): 10-14. doi:10.24911/PJNMed.175-1598982543


Web Style

Sher AC, Mahmood NF, Orth RC, Hayatghaibi SE, Sammer MBK, Seghers VJ. Radioactive iodine uptake in the breast tissue of nulliparous adolescent girls and young women. https://www.pjnmed.com/?mno=130751 [Access: February 28, 2024]. doi:10.24911/PJNMed.175-1598982543


AMA (American Medical Association) Style

Sher AC, Mahmood NF, Orth RC, Hayatghaibi SE, Sammer MBK, Seghers VJ. Radioactive iodine uptake in the breast tissue of nulliparous adolescent girls and young women. Pak J Nucl Med. 2021; 11(1): 10-14. doi:10.24911/PJNMed.175-1598982543



Vancouver/ICMJE Style

Sher AC, Mahmood NF, Orth RC, Hayatghaibi SE, Sammer MBK, Seghers VJ. Radioactive iodine uptake in the breast tissue of nulliparous adolescent girls and young women. Pak J Nucl Med. (2021), [cited February 28, 2024]; 11(1): 10-14. doi:10.24911/PJNMed.175-1598982543



Harvard Style

Sher, A. C., Mahmood, . N. F., Orth, . R. C., Hayatghaibi, . S. E., Sammer, . M. B. K. & Seghers, . V. J. (2021) Radioactive iodine uptake in the breast tissue of nulliparous adolescent girls and young women. Pak J Nucl Med, 11 (1), 10-14. doi:10.24911/PJNMed.175-1598982543



Turabian Style

Sher, Andrew C., Nadia F. Mahmood, Robert C. Orth, Shireen E. Hayatghaibi, Marla B. K. Sammer, and Victor J. Seghers. 2021. Radioactive iodine uptake in the breast tissue of nulliparous adolescent girls and young women. Pakistan Journal of Nuclear Medicine, 11 (1), 10-14. doi:10.24911/PJNMed.175-1598982543



Chicago Style

Sher, Andrew C., Nadia F. Mahmood, Robert C. Orth, Shireen E. Hayatghaibi, Marla B. K. Sammer, and Victor J. Seghers. "Radioactive iodine uptake in the breast tissue of nulliparous adolescent girls and young women." Pakistan Journal of Nuclear Medicine 11 (2021), 10-14. doi:10.24911/PJNMed.175-1598982543



MLA (The Modern Language Association) Style

Sher, Andrew C., Nadia F. Mahmood, Robert C. Orth, Shireen E. Hayatghaibi, Marla B. K. Sammer, and Victor J. Seghers. "Radioactive iodine uptake in the breast tissue of nulliparous adolescent girls and young women." Pakistan Journal of Nuclear Medicine 11.1 (2021), 10-14. Print. doi:10.24911/PJNMed.175-1598982543



APA (American Psychological Association) Style

Sher, A. C., Mahmood, . N. F., Orth, . R. C., Hayatghaibi, . S. E., Sammer, . M. B. K. & Seghers, . V. J. (2021) Radioactive iodine uptake in the breast tissue of nulliparous adolescent girls and young women. Pakistan Journal of Nuclear Medicine, 11 (1), 10-14. doi:10.24911/PJNMed.175-1598982543





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