The role of FDG‐PET/CT in suspected recurrence of breast cancer

Abstract

BACKGROUND. Early diagnosis of recurrent breast cancer is crucial to selection of the most appropriate therapy. The current study evaluated the role of FDG‐PET/CT in the assessment of suspected recurrent breast cancer in patients who presented with elevated serum tumor markers. METHODS. Forty‐seven consecutive FDG‐PET/CT studies of 46 women (aged 32–79 years; mean, 59.9 years) with a history of breast cancer presented with elevated serum tumor markers 1–21 years (mean = 6.2 years) after their initial diagnosis and were retrospectively evaluated. PET/CT results were confirmed by pathology (n = 11), further imaging, and follow‐up (mean = 17.2 months; n = 36). Changes in further management based on PET/CT were recorded. RESULTS. Thirty (65%) patients had tumor recurrence, and 16 (35%) patients showed no further evidence of disease. Thirty‐one patients had 32 abnormal PET/CT studies, and 15 patients had normal studies with an overall sensitivity, specificity, and accuracy of 90%, 71%, and 83%, respectively. In 37 patients, PET/CT was compared with contrast‐enhanced CT and had a higher sensitivity (85% vs 70%), specificity (76% vs 47%), and accuracy (81% vs 59%). PET/CT had an impact on the management of 24 (5l%) patients. Of these, chemotherapy or radiotherapy was started in 16 patients, treatment was modified in 2 patients, and 6 patients were referred to biopsy, followed by referral to surgery for 2 patients. CONCLUSIONS. In patients with breast cancer and rising tumor markers, FDG‐PET/CT had high performance indices and was superior to CT for diagnosis of tumor recurrence, which led to changes in the subsequent clinical management of 51% of these patients. Cancer 2006. © 2006 American Cancer Society.

18F-FDG PET/CT for Staging and Restaging of Breast Cancer

“…Recently, several studies pointed out that staging with 18 F-FDG PET/CT might be of value not only in patients with locally advanced disease but also in "intermediate-risk" patients (13-21)-that is, patients with clinical stage IIB disease (T2N1/T3N0) or higher-with significant diagnostic yield and prognostic information (18,19). PET/CT has also shown good performance in restaging for breast cancer patients (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35).This review assesses the advantages and limits of 18 F-FDG PET/CT in initial staging and restaging for breast cancer patients. …”

Breast Cancer Staging in a Single Session: Whole-Body PET/CT Mammography

“…18 F-FDG PET/CT accurately stages various types of tumors (9)(10)(11). In addition, whole-body 18 F-FDG PET/CT is beneficial for staging breast cancer (12)(13)(14) and for monitoring therapy in breast cancer patients (15). However, 18 F-FDG PET/CT has predominantly been used to detect distant metastases in breast cancer patients.…”

PET/CT Versus CT In Post-Operative Follow Up Of Breast Cancer Patients

“…Preliminary studies on small cohorts of patients have shown a correlation between early reduction of tumor FDG uptake and clinical response after completion of neo-adjuvant chemotherapy. [8] The patients included in this study were subdivided into three groups according to the referring cause for PET/CT post-operative follow up.…”