J Breast Cancer.  2012 Dec;15(4):441-448. 10.4048/jbc.2012.15.4.441.

The Effects of Preoperative 18F-FDG PET/CT in Breast Cancer Patients in Comparison to the Conventional Imaging Study

Affiliations
  • 1Department of Surgery, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea. yj0139@naver.com
  • 2Department of Anesthesiology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Korea.
  • 3Department of Nuclear Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.

Abstract

PURPOSE
There have been recent studies of the 18F-fluorodeoxyglucose positron emission tomography and computed tomography (18F-FDG PET/CT) in the staging, detection, and follow-up of the breast cancer occurrence and recurrence. There was controversy concerning the use of 18F-FDG PET/CT for staging primary breast cancer. In this study, we investigated the potential effects of 18F-FDG PET/CT in the initial assessment of patients with primary breast cancer.
METHODS
From January 2008 to December 2009, 154 consecutive biopsy-proven invasive breast cancer patients were enrolled in this study. Patients underwent conventional imaging studies including mammography, breast ultrasonography (USG), and magnetic resonance imaging for local assessment, and plain chest X-ray, liver USG, and bone scan to rule out distant metastasis. All 154 patients underwent 18F-FDG PET/CT in the initial assessment.
RESULTS
18F-FDG PET/CT did not detect primary breast lesions in 16 patients with a sensitivity of 89.6% and detected only 5 multiple lesions (12.5%) out of 40 cases. Histologically confirmed axillary lymph node (LN) metastases were in 51 patients, and the sensitivity and specificity of 18F-FDG PET/CT to detect metastatic axilla were 37.3% and 95.8%, respectively; whereas the corresponding estimates of USG were 41.2% and 93.7%, respectively. Eleven extra-axillary LN metastases were found in eight patients, and seven lesions were detected by 18F-FDG PET/CT only. The sensitivity and specificity of 18F-FDG PET/CT in detecting distant metastasis were 100% and 96.4%, respectively; whereas the sensitivity and specificity of the conventional imaging were 61.5% and 99.2%, respectively.
CONCLUSION
18F-FDG PET/CT cannot be recommended as a primary diagnostic procedure in breast cancer, but it has the potential to be used as an additional imaging tool for the detection of axillary metastasis, distant metastasis, and extra-axillary LN metastasis. 18F-FDG PET/CT cannot solely replace the conventional diagnostic procedure in primary breast cancer. The best approach may be the combination of different imaging modalities.

Keyword

Breast; Carcinoma; Computed tomography; Diagnostic imaging; Positron-emission tomography

MeSH Terms

Axilla
Breast
Breast Neoplasms
Diagnostic Imaging
Fluorodeoxyglucose F18
Follow-Up Studies
Humans
Liver
Lymph Nodes
Magnetic Resonance Imaging
Mammography
Neoplasm Metastasis
Positron-Emission Tomography
Positron-Emission Tomography and Computed Tomography
Recurrence
Sensitivity and Specificity
Thorax
Ultrasonography, Mammary
Fluorodeoxyglucose F18

Figure

  • Figure 1 Image findings of a 38-year-old breast cancer patient with multiple bone metastases. Mild hypermetabolism were seen at right sacrum and left iliac bone on 18F-fluorodeoxyglucose positron emission tomography and computed tomography (A, arrows) which was equivocal on bone scan (B). The lesions revealed as osteolytic bone metastasis with low SI on T1- and increased SI on T2 weighted images, with strong enhancement on contrast enhanced magnetic resonance imaging (C, arrows).


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Jun Ho Lee, Sung Yong Kim, Jeong Eon Lee, Eun Yoon Cho, Yoon-La Choi, Joon Young Choi, Sun Wook Han, Seok Won Kim, Won Ho Kil, Seok Jin Nam
J Breast Cancer. 2014;17(1):83-87.    doi: 10.4048/jbc.2014.17.1.83.

Effectiveness of Breast MRI and 18F-FDG PET/CT for the Preoperative Staging of Invasive Lobular Carcinoma versus Ductal Carcinoma
Na Young Jung, Sung Hoon Kim, Sung Hun Kim, Ye Young Seo, Jin Kyoung Oh, Hyun Su Choi, Won Jong You
J Breast Cancer. 2015;18(1):63-72.    doi: 10.4048/jbc.2015.18.1.63.


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