Molecular subtypes of breast cancer: metabolic correlation with 18F-FDG PET/CT

Vicente, Ana María García; Castrejón, Á. Soriano; Martín, A. León; López-Muñíz, Ignacio Chacón; Madero, Vicente Muñoz; Sánchez, María del Carmen; Muñoz, A. Palomar; Aunión, Ruth Espinosa; Ageitos, Ana

doi:10.1007/s00259-013-2418-7

Cited by 63 publications

(24 citation statements)

References 33 publications

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“…This association between high tumor FDG uptake and poor prognosis is consistent with previous studies [18, 19]. Higher SUV is linked with more aggressive features of breast cancers such as hormone receptor negativity, triple-negative subtype, and higher Ki-67 index [20–23]. Our result also shows that breast cancers with triple-negative or hormone receptor-negative subtype has higher tumor SUVmax.…”

Section: Discussionsupporting

confidence: 92%

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Body Mass Index with Tumor 18F-FDG Uptake Improves Risk Stratification in Patients with Breast Cancer

et al. 2016

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PurposeTo investigate the combined prognostic impact of body mass index (BMI) and tumor standardized uptake value (SUV) measured on pretreatment 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in patients with breast cancer.MethodsWe evaluated a cohort of 332 patients with newly diagnosed breast cancer (stage I-III) who underwent pretreatment FDG PET/CT followed by curative resection. Patients were categorized as overweight (BMI ≥ 23 kg/m2) or normal weight (BMI < 23 kg/m2). Primary tumor maximum SUV was measured by FDG PET/CT. Associations between BMI and tumor SUV with disease recurrence were assessed using Cox regression models.ResultsMedian follow-up was 39 months. There were 76 recurrences and 15 cancer-related deaths. Multivariable Cox regression analysis demonstrated that high tumor SUV (hazard ratio [HR] = 1.75; 95% CI, 1.02–3.02; P = 0.044) and overweight (HR = 1.84; 95% CI, 1.17–2.89; P = 0.008) were independent poor prognostic factors. Positive hormone receptor status was an independent predictor of favorable outcome (HR = 0.42; 95% CI, 0.26–0.68; P < 0.001). Overweight patients with high tumor SUV had a two-fold risk of recurrence compared to patients with normal weight or low tumor SUV after adjusting for clinical stage and tumor subtype (HR = 2.06; 95% CI, 1.30–3.27; P = 0.002).ConclusionsIn patients with breast cancer, higher tumor SUV was associated with a more adverse outcome particularly in overweight women. BMI status combined with tumor SUV data allows better risk-stratification of breast cancer, independent of clinical stage and tumor subtype.

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Section: Discussionsupporting

confidence: 92%

“…In breast cancer, high tumor standardized uptake value (SUV) on FDG PET/CT is associated with poor prognostic features such as high grade, hormone receptor negativity, triple negativity, and metaplastic tumors [18–23]. …”

Section: Introductionmentioning

confidence: 99%

Body Mass Index with Tumor 18F-FDG Uptake Improves Risk Stratification in Patients with Breast Cancer

et al. 2016

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“…The suitability of FDG-PET/CT has already been proven in breast cancer ( 12 - 14 ), but its efficacy depends on several tumor-properties, for instance histological tumor type (invasive ductal carcinomas are better candidates for PET/CT examinations than invasive lobular cancers) or proliferation rate (high Ki-67 LI is favorable in this respect) ( 47 - 49 ). FDG-uptake is also influenced by biological subtypes; Her2-positive carcinomas (and triple negative, especially basal like tumors) ( 24 ) show higher FDG-uptake than hormone receptor positive ones ( 50 , 51 ).…”

Section: Discussionmentioning

confidence: 99%

Response evaluation after primary systemic therapy of Her2 positive breast cancer – an observational cross-sectional study

Tőkés¹,

Szentmártoni²,

Torgyík³

et al. 2015

Croat Med J

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AimTo evaluate (I) trastuzumab-containing primary systemic therapy (PST) in human epidermal growth factor receptor 2 (Her2) overexpressing breast carcinomas; (II) compare the patients who achieved and those who did not achieve pathological complete remission (pCR), and (III) analyze the accuracy of different clinical-imaging modalities in tumor response monitoring.Methods188 patients who received PST between 2008 and 2014 were reviewed and 43 Her2 overexpressing breast cancer patients (28 Luminal B/Her2-positive and 15 Her2-positive) were enrolled. 26 patients received mostly taxane-based PST without trastuzumab (Group 1) and 17 patients received trastuzumab-containing PST (Group 2). We compared the concordance between pCR and complete remission (CR) defined by breast-ultrasound, CR defined by standard 18F-fluoro-deoxy-glucose positron emission tomography and computerized tomography (FDG-PET/CT) criteria (Method 1) and CR defined by a novel, breast cancer specific FDG-PET/CT criteria (Method 2). Sensitivity (sens), specificity (spec), and positive (PPV) and negative predictive values (NPV) were calculated.Results10 patients (38.5%) in Group 1 and 8 (47%) in Group 2 achieved pCR. pCR was significantly more frequent in Her2-positive than in Luminal B/Her2-positive tumors in both Group 1 (P = 0.043) and Group 2 (P = 0.029). PET/CT evaluated by the breast cancer specific criteria (PET/CT Method 2) differentiated pCR from non-pCR more accurately in both groups (Group 1: sens = 77.8%, spec = 100%, PPV = 100%, NPV = 71.4%; Group 2: sens = 87.5%, spec = 62.5%, PPV = 70%, NPV = 83.3%) than standard PET/CT criteria (Method 1) (Group 1: sens = 22.2% spec = 100% PPV = 100% NPV = 41.7%; in Group 2: sens = 37.5%, spec = 87.5%, PPV = 75% NPV = 58.3%) or breast ultrasound (Group 1, sens = 83.3% spec = 25% PPV = 62.5% NPV = 50%; Group 2, sens = 100% spec = 12.5% PPV = 41.6% NPV = 100%).ConclusionThe benefit of targeted treatment with trastuzumab-containing PST in Her2 overexpressing breast cancer was defined in terms of pCR rate. Luminal B/Her2-positive subtype needs further subdivision to identify patients who would benefit from PST. Combined evaluation of tumor response by our novel, breast cancer specific FDG-PET/CT criteria accurately differentiated pCR from non-pCR patients.

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“…Ki-67 proliferation index were scored as positive with a cut-off of 14%. [ 8 ] ER, PR, and HER2 status were available for 76 tumors (86.6%) and Ki-67 index for 68 tumors (77%). Furthermore, only in four patients, T stage, lymph nodal involvement, and histological grade were not obtained from the records.…”

Section: Methodsmentioning

confidence: 99%

2-(fluorine-18)-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography after breast conserving surgery: Correlation with molecular markers of breast cancer

et al. 2016

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Aim:To investigate the role of 2-(fluorine-18)-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) early after breast-conserving surgery (BCS) in patients with breast cancer (BC) and whether we can determine which molecular biomarkers of breast carcinoma put the patients at risk.Materials and Methods:This retrospective study involved 88 patients with histologically proven T1 or T2 BC, who were treated with BCS and underwent 18F-FDG PET/CT study. The correlation between biological markers (estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 [HER2], and Ki-67) of the primary tumor and 18F-FDG PET/CT findings was analyzed.Results:18F-FDG PET/CT demonstrated the presence of BC disease (locoregional disease [LRD], distant metastases, or contralateral BC) in 26 of 88 patients (29.5%). Regarding immunohistochemical profiles, BC expressing high levels of Ki-67 were associated with an increased percentage of LRD, which was the major recurrence pattern on 18F-FDG PET/CT. Although the BC disease was observed more commonly in patients with HER2 positivity compared to those of HER2 negative, the difference did not reach statistical significance. The patients with T2 tumor or a higher histopathological grade had a higher percentage of BC disease.Conclusions:This study demonstrated that patients with early stage BC treated with BCS have a remarkable risk of the presence of BC even early after surgery, and there was a clinically important relationship between 18F-FDG PET/CT findings and biological markers of BC. These findings suggest that high-risk molecular biomarkers (Ki-67, HER2) can be taken into account in the decision-making the process for both preoperative imaging and planning of the surgical approach.

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Molecular subtypes of breast cancer: metabolic correlation with 18F-FDG PET/CT

Abstract: Semiquantitative metabolic parameters showed statistically significant differences among the molecular subtypes of the tumours evaluated. Therefore, there seems to be a relationship between molecular and glycolytic phenotypes.

Cited by 63 publications

References 33 publications

Body Mass Index with Tumor 18F-FDG Uptake Improves Risk Stratification in Patients with Breast Cancer

Body Mass Index with Tumor 18F-FDG Uptake Improves Risk Stratification in Patients with Breast Cancer

Response evaluation after primary systemic therapy of Her2 positive breast cancer – an observational cross-sectional study

2-(fluorine-18)-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography after breast conserving surgery: Correlation with molecular markers of breast cancer

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