Analysis of incidental focal hypermetabolic uptake in the breast as detected by 18F-FDG PET/CT: clinical significance and differential diagnosis

Abstract

Incidental focal 18F-FDG uptake in the breast as detected by PET/CT was indicative of malignancy in 45% of patients. Both mean SUV(max) and diameter were greater for malignant than benign lesions.

Role of combined BI-RADS assessment using mammography and sonography for evaluation of incidental hypermetabolic lesions in the breast on 18F-FDG PET-CT

“…The former reflects the lower incidence of breast cancer in Korea (25), and the latter may be related to subjective visual assessment by the three nuclear medicine physicians. The malignancy rate in the current study was lower than that in other reports (37.5-83.3%) (16)(17)(18)(19)(20). This might be due to a higher proportion of excluded patients (23.3 vs. 0-9.0%) who underwent no histologic confirmation or insufficient follow-up.…”

“…The incidence of incidental hypermetabolic lesions in the current study was lower than that of the Western population (0.8-1.1%) but higher than that of the Korean population (0.4%) (16)(17)(18)(19)(20). The former reflects the lower incidence of breast cancer in Korea (25), and the latter may be related to subjective visual assessment by the three nuclear medicine physicians.…”

Multicentric study on 18F-FDG-PET/CT breast incidental uptake in patients studied for non-breast malignant purposes

“…[9][10][11][12][13][14][15][16][17][18][19][20][21][22] Results on the prevalence of BIU and their malignancy rate in the most important studies and in the present are summarised in Table 1 The nodule at CT was 20 mm of diameter, SUV max was 2.7, BIU to liver ratio was 0.9 and BIU to blood-pool ratio was 0.5. After biopsy the final diagnosis was fibroadenoma.…”

“…In the study of Kang et al 15 13,897 female patients who underwent 18 F-FDG-PET/CT for non-breast malignancies were retrospectively evaluated; fifty women had BIU but two patients were lost to follow-up; 18 (37.5%) had confirmed malignancy while 30 (62.5%) had benign lesions. Chae et al 16 observed 131 BIU in 32,988 patients; seventy-one patients underwent further investigations 32 of which had histologically malignant lesions and 28 benign ones. Breast lesions in the remaining 11 patients, who showed no further evidence of breast malignancy over at least 2-years follow-up, were considered to be clinically benign.…”

“…8 Despite screening procedures, the available data reporting BIU detected by 18 F-FDG-PET or PET/CT suggest that some lesions are still missed during traditional screening work-up. [9][10][11][12][13][14][15][16][17][18][19][20][21][22] When a BIU is detected, it creates for a management dilemma requiring further investigations. Overall, the prevalence of BIU on all scan ranges from 0.11% to 0.83%, with pooled estimate of 0.40%; the prevalence of BIU on scans performed on female patients only ranges from 0.36% to 1.84%, with pooled estimate of 0.82%; the pooled malignancy risk of BIU who undergo further investigations ranges from 18% to 100% with pooled estimate of 48%; the pooled malignancy risk of BIU who undergo histological examination ranges from 51% to 100% with pooled estimate of 60%.…”