MUGA Scan for Heart with Low-risk Bca

ABSTRACT: Is MUGA Scan Necessary in Patients With Low-Risk Breast Cancer Before Doxorubicin-Based Adjuvant Therapy? [07/30/2001; American Journal of Clinical Oncology]

Doxorubicin-based chemotherapy in the adjuvant treatment of breast cancer has become standard. Use of doxorubicin is limited by cardiac dysfunction; however, the incidence is dramatically reduced by limiting the dose to less than 550 mg/m2.

Although the cumulative dose in breast cancer is typically 240 mg/m2, multiple gated acquisition (MUGA) scans are still recommended for determining cardiac functional status in these patients. To examine the need for this practice, we reviewed 296 patients who underwent surgery for breast cancer at Roswell Park Cancer Institute between July 1997 and December 1998. Fifty-nine of 95 (62%) patients receiving doxorubicin-based regimens, and 3 of 39 (7%) receiving nondoxorubicin regimens had pretreatment MUGA scans.

The MUGA scans showed normal results in 58 patients and low-normal in 4 (6.5%), with no wall motion abnormalities encountered. There were no cases where doxorubicin was not used because of an abnormal MUGA scan. There were no cardiac complications in the 59 women who received doxorubicin-based chemotherapy. MUGA will screen out few, if any, women under consideration for doxorubicin-based adjuvant therapy; the decision to avoid doxorubicin can be made based on age and preexisting comorbidity.

Guidelines recommending routine use of MUGA before the administration of doxorubicin for adjuvant therapy for breast cancer should be reconsidered.

Ann's NOTE: I wonder why the recommendation is being made after looking at 59 women. So few studies end with definitive results, yet here is one with a SMALL group of women that is.

My cynical self suggests that this is related to REDUCING COSTS! Oh, no that cannot be, could it?

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