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
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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