Nucl Med Mol Imaging.  2013 Dec;47(4):263-267.

The Prognostic Value of 18F-FDG PET/CT for Early Recurrence in Operable Breast Cancer: Comparison with TNM Stage

• O JH
• Choi WH
• Han EJ
• Choi EK
• Chae BJ
• Park YG
• Kim SH

Abstract

PURPOSE
We evaluated whether the maximum standardized uptake values (SUVmax) of primary tumor from the initial staging by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of patients with breast cancer could identify patients at risk for early recurrence within 2 years, particularly in comparison to the American Joint Committee on Cancer (AJCC) stage.
METHODS
We reviewed the staging 18F-FDG PET/CT images of patients with primary breast cancer and their medical records. The SUVmax of the primary tumor was measured. The presence or absence of FDG uptake in the axillary lymph node (ALN) was also assessed. The patient's pathologic primary tumor stage (pT), pathologic regional lymph node stage (pN), stage grouping, age, estrogen receptor (ER) and progesterone receptor (PR) status, and neoadjuvant chemotherapy history were evaluated with the FDG uptake parameters for recurrence within 2 years following the end of first-line therapy.
RESULTS
Recurrence within 2 years was present in 9.1%(n=40) out of the 441 patients assessed. The FDG uptake in ALN, pT, pN, stage grouping and neoadjuvant chemotherapy history were prognostic for early recurrence, while primary tumor SUVmax, age, and ER or PR status were not significant on logistic regression. On multivariate analysis, only the stage grouping (odds ratio 2.79; 95 % CI 1.73, 4.48; p<0.0001) and neoadjuvant chemotherapy history (odds ratio 2.70; 95 % CI 1.22, 5.98; p=0.0141) could identify patients at increased risk for recurrence within 2 years.
CONCLUSIONS
Primary tumor FDG uptake measured by SUVmax, and visual assessment of FDG uptake in the ALN in the initial staging PET/CT of patients with breast cancer may not have additional prognostic value compared with the AJCC stage grouping for early recurrence.

Keyword

18F-FDG PET/CT; Breast cancer; Prognosis; Staging

MeSH Terms

Breast Neoplasms*
Breast*
Drug Therapy
Electrons
Estrogens
Fluorodeoxyglucose F18*
Humans
Joints
Logistic Models
Lymph Nodes
Medical Records
Multivariate Analysis
Positron-Emission Tomography and Computed Tomography*
Prognosis
Receptors, Progesterone
Recurrence*
Estrogens
Fluorodeoxyglucose F18
Receptors, Progesterone