Correlation of maximum standardized uptake values in 18F-Fluorodeoxyglucose positron emission tomography-computed tomography scan with immunohistochemistry and other prognostic factors in breast cancer

Abubakar, Zakir Ali; Akepati, Naveen Kumar Reddy; Bikkina, Prathyusha

doi:10.4103/ijnm.ijnm_94_18

Cited by 13 publications

(13 citation statements)

References 22 publications

(23 reference statements)

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“…In the present study, the SUVmax are in the following order: luminal A < luminal B < Her2 enriched < TNBC. The SUVmax of the primary lesion increases with an increase in the size of the tumor (p = 0.01), similar to the findings by Lee et al, 12 Sanli et al, 15 Abubakar et al 16 Likewise, the stratification of T4 tumors by size (to <5 cm and >5 cm) has shown higher SUVmax in larger tumors but was not significant (p = 0.94).…”

Section: Discussionsupporting

confidence: 85%

“…Proliferation indices such as ki‐67 and MIB1 are proven biomarkers in breast cancer, but they were not analyzed due to the paucity of available data. The SUVmax of the primary lesion increases with an increase in the size of the tumor ( p = 0.01), similar to the findings by Lee et al., 12 Sanli et al., 15 Abubakar et al 16 . Likewise, the stratification of T4 tumors by size (to <5 cm and >5 cm) has shown higher SUVmax in larger tumors but was not significant ( p = 0.94).…”

Section: Discussionsupporting

confidence: 85%

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Correlation of 18‐fluorodeoxyglucose uptake values on PET–CT scan with histological prognostic markers in breast cancer

Muduly

Rebba

Sultania

et al. 2022

Asia-Pac J Clncl Oncology

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Background Positron emission tomography–computed tomography (PET‐CT) scan utilizes 18‐fluorodeoxyglucose (18‐FDG), based on the principle of higher glycolytic activity and reduced glucose‐6‐phosphatase levels in cancer cells. This imaging modality is usually advised in the metastatic evaluation of stage III breast cancer patients. The correlation of maximum standard uptake values of primary lesion with different pathological and molecular markers has not been studied extensively. Methods Retrospective analysis of the data was performed from our prospectively maintained breast cancer database. All the patients who had undergone 18‐FDG PET–CT scan at initial evaluation for staging between June 2017 and April 2020 were included in the study. One‐way ANOVA test or Student's t‐test as appropriate was performed to assess the difference of means in maximum standard uptake values (SUVmax) of the primary lesion and axillary nodes with clinical stage, histological grade, molecular subtype. Bonferroni post hoc test was also applied. Results Out of 388 patients in the breast cancer database, 45 patients met inclusion criteria. There was a significant correlation of molecular subtype (p = 0.029) with SUVmax of the primary lesion. Higher primary SUVmax was associated with higher T stage (p = 0.01) and higher histological grade (p = 0.06). In each molecular subtype, there was an increase in mean SUVmax of the primary lesion with increasing histological grade and vice versa. Conclusions SUVmax of the primary lesion in breast cancer patients reflects tumor biology. Higher SUVmax can predict patients with triple‐negative breast cancers and higher grades in primary tumors. However, further large‐scale validatory studies are essential.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 85%

Correlation of 18‐fluorodeoxyglucose uptake values on PET–CT scan with histological prognostic markers in breast cancer

Muduly

Rebba

Sultania

et al. 2022

Asia-Pac J Clncl Oncology

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“…For example, although PET scans are highly effective in the detection of extra-axillary nodal and distant metastases in more locally advanced breast cancers, they have not demonstrated significant benefit for patients with early-stage breast cancer. [2][3][4] Furthermore, although some studies suggest a potential diagnostic benefit of PET-CT for clinical stage IIB patients, these imaging modalities do not show significant benefit in the detection of distant metastases in early-stage breast cancers with low likelihood of metastatic spread, such as ductal carcinoma in situ and lesions clinically staged as I and IIA. [5][6][7][8] Thus, although CT and PET-CT can be instrumental in the identification of distant metastases in clinically advanced breast cancer, their use in early-stage breast cancers is low in yield relative to false-positive rates.…”

Section: Introductionmentioning

confidence: 99%

Clinical Impact of ASCO Choosing Wisely Guidelines on Staging Imaging for Early-Stage Breast Cancers: A Time Series Analysis Using SEER-Medicare Data

Baltz

Siegel

Kamal

et al. 2023

JCO Oncology Practice

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PURPOSE: American Society for Clinical Oncology released the Choosing Wisely list in 2012, highlighting low-value procedures that lack evidence, advising against the use of positron emission tomography, computerized tomography, and radionuclide bone scans for the staging of early-stage breast cancer at low risk for metastasis. The objective of the study was to assess the impact of the American Society of Clinical Oncology Choosing Wisely guidelines on inappropriate staging imaging among early-stage breast cancers. METHODS: The Surveillance, Epidemiology, and End Results Program-Medicare data set was used to identify 50,004 women age 66 years and older with new incident diagnosis of early-stage breast cancer (stage 0 through stage 2a; T < 4, N = 0, and M = 0). The primary outcome was the incidence of patients with inappropriate imaging following an early-stage breast cancer diagnosis. The primary outcome was identified within 6 months of the first diagnosis. An interrupted time series analysis using negative binomial regression was performed for outpatient claims for these diagnostic studies versus the two interruptions of guidelines release and guidelines reinforcement. Mean images per patient, percent change for the study period, and rate of change per year were calculated. RESULTS: Imaging rates fell by a modest 2.32% following guidelines release in April 2012 (point estimate = −2.32%; 95% CI, −6.34% to 1.88%). By contrast, imaging rates fell by a four-fold larger amount (point estimate = −9.36%; 95% CI, −13.20% to −5.35%) following guidelines published reminders in journals (or reinforcement) in October 2013. Mean imaging studies per patient (95% CI) declined from 1.80 (1.76 to 1.84) in January 2012 to 1.50 (1.48 to 1.53) by January 2015, representing a 16% decline in imaging overuse in 2015 compared with 3 years earlier. The rate of change (95% CI) in images per patient was initially small at −0.47% (−4.27% to 3.33%) per year between April 2012 and October 2013, but almost eight times faster at −3.70% (−5.81% to −1.60%) per year after October 2013. CONCLUSION: This analysis demonstrates a substantial decrease in the prevalence of imaging overuse in early-stage breast cancers correlating with the 2013 reinforcement of American Society of Clinical Oncology's 2012 Choosing Wisely guidelines. The creation and dissemination of such resources serves as a powerful tool to improve clinical practice, cost-effectiveness, and patient safety from secondary malignancies, anxiety, and overdiagnosis.

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“…The preferred method to stage breast cancer patients was also changed from chest X-ray and abdominal ultrasound to a computerized axial tomography (CAT) scan of the thorax and abdomen [5]. The reason for this proposal is the higher sensitivity of the latter, although only data of a direct comparison between conventional staging and PET/CT exist [10,11].…”

Section: Introductionmentioning

confidence: 99%

Staging for Breast Cancer: A Nationwide Survey about Adherence to Guidelines in German Breast Centers

et al. 2022

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Introduction: The risk for metastasis at primary diagnosis of breast cancer is about 4%. The German guidelines give clear indications for when, whom and how to stage breast cancer patients. Ideally, this should be done via CAT scan of the thorax and abdomen and an additional bone scan. But daily practice shows that the way health care providers handle staging recommendations can vary. To objectify adherence to guidelines we started a nation-wide survey. Methods: Between July and September 2020 we sent out a survey via email to all certified and non certified breast centers and in addition to all Departments of Obstetrics and Gynecology in Germany. We asked for timing of staging, conditions that cause staging and the applied method. In case we did not get back any reply we sent out a reminder. Results: A total of 220 certified breast centers/28 non-certified breast center/48 Departments of Gynecology and Obstetrics who care for breast cancer patients took part in our survey. A general pre-therapeutic staging was performed in 16,4%/39,3%/66,7% of all institutions and a general post-operative staging was performed in 4,1%/0%/6,3% of each institutional type, respectively. In terms of the applied method, 75% of all certified breast centers used a CAT scan and bone scan, while 23,3% primarily use chest x-ray, ultrasound of the abdomen (27,7%) or MRI. As a potential reason for using x-ray and ultrasound the presence of a „low-risk“ breast cancer was mentioned. Summary: Although certified breast centers show the highest adherence to current guidelines, some still perform a general staging or do not use the recommended staging method. The low probability for primary metastatic breast cancer and the use of a reasonable exposure to radiation warrant a critical discussion.

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Correlation of maximum standardized uptake values in 18F-Fluorodeoxyglucose positron emission tomography-computed tomography scan with immunohistochemistry and other prognostic factors in breast cancer

Cited by 13 publications

References 22 publications

Correlation of 18‐fluorodeoxyglucose uptake values on PET–CT scan with histological prognostic markers in breast cancer

Correlation of 18‐fluorodeoxyglucose uptake values on PET–CT scan with histological prognostic markers in breast cancer

Clinical Impact of ASCO Choosing Wisely Guidelines on Staging Imaging for Early-Stage Breast Cancers: A Time Series Analysis Using SEER-Medicare Data

Staging for Breast Cancer: A Nationwide Survey about Adherence to Guidelines in German Breast Centers

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