The Effects of Estrogen, Progesterone, and C-erbB-2 Receptor States on 18F-FDG Uptake of Primary Breast Cancer Lesions

Abstract

The purpose of this prospective study was to investigate whether correlations exist between 18 F-FDG uptake of primary breast cancer lesions and predictive and prognostic factors such as estrogen receptor (ER), progesterone receptor (PR), and C-erbB-2 receptor (C-erbB-2R) states. Methods: Before undergoing partial or total mastectomy, 213 patients with newly diagnosed breast cancer underwent 18 F-FDG PET (5.2 MBq/kg of body weight). The maximum standardized uptake value (SUV) of the primary lesion was measured in each patient. Standard immunohistochemistry was performed on a surgical specimen of the cancer lesion to characterize the receptor state of the tumor cells. Pearson x 2 tests were performed on the cross-tables of different receptor states to test any association that may exist among ER, PR, and C-erbB-2R. Maximum SUV measurements for different receptor states were compared using factorial ANOVA in a completely random design. Results: After exclusion of certain lesions, 118 lesions were analyzed for this study. The mean maximum SUVs of ER-positive and ER-negative lesions were 3.03 6 0.26 and 5.64 6 0.75, whereas those of PR were 3.24 6 0.29 and 4.89 6 0.67, respectively, and those of C-erbB-2R were 4.64 6 0.70 and 3.70 6 0.35, respectively. x 2 tests for ER and PR showed that if one is positive then the other tends to be positive as well (x 2 5 71.054, P , 0.01). For ER and C-erbB-2R states, if ER is positive, C-erbB-2R will more likely be negative (x 2 5 13.026, P , 0.01). No relationship was detected between PR and C-erbB-2R states (x 2 5 3.695, P . 0.05). ANOVAs showed that PR state alone (F 5 0.095, P . 0.05) and C-erbB-2R state alone (F 5 0.097, P . 0.05) had no effect on 18 F-FDG uptake but ER state alone had an effect (F 5 9.126, P , 0.01). ER and PR being together had no additional effect on 18 F-FDG uptake. Our study also demonstrated that interactions exist between ER and C-erbB-2R state and between PR and C-erbB-2R state. Conclusion: SUV measurements may provide valuable information about the state of ER, PR, and C-erbB-2R and the associated glucose metabolism as measured by 18 F-FDG uptake of the primary breast cancer lesions. Such an association may be of importance to treatment planning and outcome in these patients.

Prognostic Value of Primary Tumor Uptake on F-18 FDG PET/CT in Patients with Invasive Ductal Breast Cancer

“…This tendency has also been reported previously [11][12][13][14][15][16]. Kawamura et al demonstrated that FDG uptake was affected by the number of metabolically active tumor cells [17].…”

18F-FDG Small-Animal PET/CT Differentiates Trastuzumab-Responsive from Unresponsive Human Breast Cancer Xenografts in Athymic Mice

“…Clinical studies have also found a positive correlation between Ki67 staining and uptake of 18 F-FDG in BC (31)(32)(33)(34), although this relationship is not well defined for lobular carcinoma, which has lower uptake of 18 F-FDG than does ductal carcinoma (31)(32)(33)35). Clinically, most data suggest there is no relationship between HER2 expression evaluated by immunohistochemical staining and tumor uptake of 18 F-FDG (32)(33)(34)36). Only Ueda et al found a positive correlation between expression of HER2 and tumor uptake of 18 F-FDG (35).…”

The Relationship Between Estrogen Receptor, Progesterone Receptor and Human Epidermal Growth Factor Receptor 2 Expression of Breast Cancer and the Retention Index in Dual Phase 18F-FDG PET/CT

“…Conflicting results have been reported as the correlation between FDG uptake and PR status. Some studies have claimed higher SUVmax in the PR (−) breast cancer [39,40], but other reports showed no association between PR status and FDG uptake [41,42]. Ekmekcioglu et al [42] suggested that the cut-off level of the PR limit of positivity might be relevant to the result.…”