Last update Feb. 14, 2024

Gallium-67 (67Ga)

High Risk

Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.

Gallium-67 (67Ga) is a radioactive isotope of gallium. It is used in the form of intravenous injection of gallium-67 citrate to detect certain lymphomas and carcinomas and some inflammatory lesions.

67Ga has a long elimination radioactive half-life of 78 hours: 3.3 days (ACMUI 2019); the biological half-life of gallium citrate is 48 to 68 hours (Mountford 1989) and is detected in breast milk for at least 2 weeks. (Rubow 1991, Tobin 1976, Larson 1971) and in the infant intestine. (Rubow 1991)

Nuclear medicine centers can measure the radioactivity of milk to determine when breastfeeding can be safely resumed. (Stabin 2000) 

Following administration of 67Ga, a 21 to 28 day breastfeeding interruption is recommended (Mattsson 2021, ACMUI 2019, IAEA 2018 p283, Sachs 2013, ICRP 2008 p164, Mountford 1999) so that the infant does not receive a radiation dose greater than 1 mSv. (Mattsson 2021)

Other agencies (US.NCR 2016 pU-10) propose breastfeeding interruption times depending on the dose administered: 

  • 1 month for 150 MBq [4 mCi].
  • 2 weeks for 50 MBq [1.3 mCi].
  • 1 week for 7 MBq [0.2 mCi].

If, despite this long period, the mother wishes to continue breastfeeding, it is advisable:

  • Have milk expressed prior to the test available to administer during the interruption period or feed with a breast milk substitute.
  • Express milk regularly during the interruption period, which can be stored frozen and used again after 10 physical half-lives of 67Ga, i.e. 33 days, during which time the radioactivity has disappeared. (LactMed)

A dose of less than 190 MBq of 67Ga administered to the mother does not require avoiding close contact with the baby. (Mountford 1999)

Alternatives

We do not have alternatives for Gallium-67 (67Ga).

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Gallium-67 (67Ga) in other languages or writings:

Pharmacokinetics

Variable Value Unit
78.2 (rad.); 48-68 (biol.) hours

References

  1. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consulted on April 16, 2024 Full text (link to original source)
  2. Mattsson S, Leide-Svegborn S, Andersson M. X-RAY AND MOLECULAR IMAGING DURING PREGNANCY AND BREASTFEEDING-WHEN SHOULD WE BE WORRIED? Radiat Prot Dosimetry. 2021 Oct 12;195(3-4):339-348. Abstract Full text (link to original source)
  3. IAEA - International Atomic Energy Agency. Radiation Protection and Safety in Medical Uses of Ionizing Radiation IAEA Safety Standards Series No. SSG-46, 2018 Abstract Full text (link to original source)
  4. US.NRC - Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards. Apéndice U, Tabla U.3. Consolidated guidance about materials licenses. Program-specific guidance about medical use licenses. Draft Report for Comment. Appendix U, Table U.3. NUREG-1556. Vol.9, Rev 3. 2016 Full text (link to original source) Full text (in our servers)
  5. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013 Sep;132(3):e796-809. Abstract Full text (link to original source) Full text (in our servers)
  6. ICRP. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP Publication 53. ICRP Publication 106. Annex D. Recommendations on breast-feeding interruptions, p. 163-165. Ann ICRP. 2008 Abstract Full text (link to original source) Full text (in our servers)
  7. Stabin MG, Breitz HB. Breast milk excretion of radiopharmaceuticals: mechanisms, findings, and radiation dosimetry. J Nucl Med. 2000 Abstract Full text (link to original source) Full text (in our servers)
  8. Mountford PJ, O'Doherty MJ. Exposure of critical groups to nuclear medicine patients. Appl Radiat Isot. 1999 Abstract
  9. Rubow S, Klopper J, Scholtz P. Excretion of gallium 67 in human breast milk and its inadvertent ingestion by a 9-month-old child. Eur J Nucl Med. 1991;18(10):829-33. Abstract
  10. Mountford PJ, Coakley AJ. A review of the secretion of radioactivity in human breast milk: data, quantitative analysis and recommendations. Nucl Med Commun. 1989 Abstract
  11. Tobin RE, Schneider PB. Uptake of 67Ga in the lactating breast and its persistence in milk: case report. J Nucl Med. 1976 Dec;17(12):1055-6. Abstract Full text (link to original source)
  12. Larson SM, Schall GL. Gallium 67 concentration in human breast milk. JAMA. 1971 Oct 11;218(2):257. No abstract available. Abstract

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