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Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Case Report

Breast I-131 Uptake in a Postpartum Woman with Thyroid Cancer: A Case Report

Author(s): Jie Qiao and Ni Zeng*

Volume 19, Issue 12, 2023

Published on: 16 March, 2023

Article ID: e200223213822 Pages: 4

DOI: 10.2174/1573405619666230220140828

Price: $65

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Abstract

Background: I-131 uptake in the breast could be occasionally observed in differentiated thyroid cancer who received I-131 scintigraphy or therapy. Herein, we report a postpartum patient with papillary thyroid cancer with breast uptake who received I-131 therapy.

Case Report: A 33-year-old postpartum woman with thyroid cancer received 120mCi(4440MBq) I- 131 therapy 5 weeks after she ceased to breastfeed. The second day after ingestion of I-131, wholebody scintigraphy demonstrated asymmetric and marked uptake in bilateral breasts. The radiation dose of I-131 in the lactating breast would decrease rapidly by reducing the activity of breasts and expressing breast milk with an electric pump once daily.

Results: The sixth day after administration, scintigraphy demonstrated weak uptake in bilateral breasts.

Conclusion: Physiologic I-131 uptake in the breast could occur in a postpartum woman with thyroid cancer who received I-131 therapy. In this patient, we find that the radiation dose of I-131 accumulated in the lactating breast would decrease rapidly through reducing the activity of breasts and expressing breast milk with an electric pump, which may be a better choice for the postpartum patient who was not given lactation-inhibiting medications and had I-131 therapy.

Graphical Abstract

[1]
Chung JK. Sodium iodide symporter: Its role in nuclear medicine. J Nucl Med 2002; 43(9): 1188-200.
[PMID: 12215558]
[2]
Kogai T, Taki K, Brent GA. Enhancement of sodium/iodide symporter expression in thyroid and breast cancer. Endocr Relat Cancer 2006; 13(3): 797-826.
[http://dx.doi.org/10.1677/erc.1.01143] [PMID: 16954431]
[3]
Riesco-Eizaguirre G, Santisteban P. A perspective view of sodium iodide symporter research and its clinical implications. Eur J Endocrinol 2006; 155(4): 495-512.
[http://dx.doi.org/10.1530/eje.1.02257] [PMID: 16990649]
[4]
Gholamrezanezhad A, et al. 12 Chapters on Nuclear Medicine. Rijeka: InTech 2011; p. pp 316.
[http://dx.doi.org/10.5772/1257]
[5]
Honour AJ, Myant NB, Rowlands EN. Secretion of radioiodine in digestive juices and milk in man. Clin Sci 1952; 11(4): 449-62.
[PMID: 13009898]
[6]
Cho JY, Léveillé R, Kao R, et al. Hormonal regulation of radioiodide uptake activity and Na+/I- symporter expression in mammary glands. J Clin Endocrinol Metab 2000; 85(8): 2936-43.
[http://dx.doi.org/10.1210/jc.85.8.2936] [PMID: 10946907]
[7]
Tazebay UH, Wapnir IL, Levy O, et al. The mammary gland iodide transporter is expressed during lactation and in breast cancer. Nat Med 2000; 6(8): 871-8.
[http://dx.doi.org/10.1038/78630] [PMID: 10932223]
[8]
Welcsh PL, Mankoff DA. Taking up iodide in breast tissue. Nature 2000; 406(6797): 688-9.
[http://dx.doi.org/10.1038/35021173] [PMID: 10963582]
[9]
Bakheet SM, Hammami MM. Patterns of radioiodine uptake by the lactating breast. Eur J Nucl Med 1994; 21(7): 604-8.
[http://dx.doi.org/10.1007/BF00285581] [PMID: 7957345]
[10]
Oh JR, Ahn BC. False-positive uptake on radioiodine whole-body scintigraphy: Physiologic and pathologic variants unrelated to thyroid cancer. Am J Nucl Med Mol Imaging 2012; 2(3): 362-85.
[PMID: 23133823]
[11]
Dilsizian V, Metter D, Palestro C, et al. Advisory Committee on Medical Uses of Isotopes (ACMUI) Sub-Committee on Nursing Mother Guidelines for the Medical Administration of Radioactive Material. 2019. Available form: https://www.nrc.gov/docs/ML1903/ML19038A498.pdf
[12]
De Groot L, Abalovich M, Alexander EK, et al. Management of thyroid dysfunction during pregnancy and postpartum: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2012; 97(8): 2543-65.
[http://dx.doi.org/10.1210/jc.2011-2803] [PMID: 22869843]
[13]
Basu S, Moghe SH. Unusual unilateral breast 131I uptake related to breastfeeding practice. Clin Radiol 2009; 64(7): 743-4.
[http://dx.doi.org/10.1016/j.crad.2009.02.014] [PMID: 19520222]
[14]
Bakheet SMB, Powe J, Hammami MM. Unilateral radioiodine breast uptake. Clin Nucl Med 1998; 23(3): 170-1.
[http://dx.doi.org/10.1097/00003072-199803000-00011] [PMID: 9509935]
[15]
Brzozowska M, Roach PJ. Timing and potential role of diagnostic I-123 scintigraphy in assessing radioiodine breast uptake before ablation in postpartum women with thyroid cancer: A case series. Clin Nucl Med 2006; 31(11): 683-7.
[http://dx.doi.org/10.1097/01.rlu.0000242600.23386.1a] [PMID: 17053384]
[16]
Hsiao E, Huynh T, Mansberg R, Bautovich G, Roach P. Diagnostic I-123 scintigraphy to assess potential breast uptake of I-131 before radioiodine therapy in a postpartum woman with thyroid cancer. Clin Nucl Med 2004; 29(8): 498-501.
[http://dx.doi.org/10.1097/01.rlu.0000132953.07351.65] [PMID: 15249829]
[17]
Sinha A, Bradley KM, Steatham J, Weaver A. Asymmetric breast uptake of radioiodine in a patient with thyroid malignancy: Metastases or not? J R Soc Med 2008; 101(6): 319-20.
[http://dx.doi.org/10.1258/jrsm.2008.080040] [PMID: 18515780]
[18]
Hu LH, Wang SJ, Liu RS. Hyperprolactinemia-related 131I uptake in nonlactating breasts. Clin Nucl Med 2012; 37(3): e57-8.
[http://dx.doi.org/10.1097/RLU.0b013e318233639d] [PMID: 22310272]
[19]
Hammami MM, Bakheet S. Radioiodine breast uptake in nonbreastfeeding women: Clinical and scintigraphic characteristics. J Nucl Med 1996; 37(1): 26-31.
[PMID: 8543996]
[20]
Perros P, Mallick UK, Fenwick JD. Radioiodine uptake in normal female breasts and liver of a patient with differentiated thyroid cancer imaged by whole body scanning. Thyroid 2003; 13(5): 511.
[http://dx.doi.org/10.1089/105072503322021205] [PMID: 12855021]
[21]
Chisholm RC, Chung EB, Tuckson W, Khan T, White JE. Follicular carcinoma of the thyroid with metastasis to the breast. J Natl Med Assoc 1980; 72(11): 1101-4.
[PMID: 7441790]
[22]
Ascani S, Nati S, Liberati F, Farabi R, Farabi R. Breast metastasis of thyroid follicular carcinoma. Acta Oncol 1994; 33(1): 71-3.
[http://dx.doi.org/10.3109/02841869409098381] [PMID: 8037794]
[23]
Fiche M, Cassagnau E, Aillet G, et al. Breast metastasis from a “tall cell variant” of papillary thyroid carcinoma. Ann Pathol 1998; 18(2): 130-2.
[PMID: 9608866]
[24]
Berger F, Unterholzner S, Diebold J, Knesewitsch P, Hahn K, Spitzweg C. Mammary radioiodine accumulation due to functional sodium iodide symporter expression in a benign fibroadenoma. Biochem Biophys Res Commun 2006; 349(4): 1258-63.
[http://dx.doi.org/10.1016/j.bbrc.2006.08.170] [PMID: 16982034]
[25]
Wapnir IL, Goris M, Yudd A, et al. The Na+/I- symporter mediates iodide uptake in breast cancer metastases and can be selectively down-regulated in the thyroid. Clin Cancer Res 2004; 10(13): 4294-302.
[http://dx.doi.org/10.1158/1078-0432.CCR-04-0074] [PMID: 15240514]
[26]
Eskin BA. Iodine and mammary cancer. Adv Exp Med Biol 1978; 91: 293-304.
[http://dx.doi.org/10.1007/978-1-4684-0796-9_20] [PMID: 343535]
[27]
Preston DL, Mattsson A, Holmberg E, Shore R, Hildreth NG, Boice JD Jr. Radiation effects on breast cancer risk: A pooled analysis of eight cohorts. Radiat Res 2002; 158(2): 220-35.
[http://dx.doi.org/10.1667/0033-7587(2002)158[0220:REOBCR]2.0.CO;2] [PMID: 12105993]
[28]
Zheng T, Holford TR, Mayne ST, et al. Radiation exposure from diagnostic and therapeutic treatments and risk of breast cancer. Eur J Cancer Prev 2002; 11(3): 229-35.
[http://dx.doi.org/10.1097/00008469-200206000-00006] [PMID: 12131656]

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