Use of positron emission tomography-computed
tomography to predict axillary metastasis in patients
with triple-negative breast cancer

Youm, Jung Hyun; Chung, Y.H.; Yang, You; Han, Seok Joo; Song, Jeong Yoon

doi:10.14216/kjco.18023

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…To date, studies on the prediction of axillary metastasis using the subtypes, but not in the triple negative subtype [11]. In contrast, one study reported that PET was the optimal tool in detecting ALN metastasis in the triple negative subtype compared to the other three subtypes, with a sensitivity of 87.0% and specificity of 67.3% [12]. However, in this study, the ratio of the ALN to the primary tumor SUVmax was used.…”

Section: Discussionmentioning

confidence: 92%

Predictive Value of the Standardized Uptake Value of 18F-fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in Assessing Axillary Lymph Node Metastasis in Different Subtypes of Breast Cancer

Kim

Choi

et al. 2019

J Breast Dis

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This study aimed to examine the association between the maximum standardized uptake value (SUVmax) of different molecular subtypes of primary breast cancer with axillary lymph node (ALN) metastasis. Methods: The medical records of 633 patients, who underwent 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET/CT) for preoperative staging, were retrospectively reviewed. The cohort was stratified by the following molecular subtypes with immunohistochemical examination: luminal A, luminal B, human epidermal growth factor receptor 2 positive (HER2+), and triple negative. We evaluated the optimal cutoff SUVmax to predict ALN metastasis in each subtype using the receiver operating characteristic (ROC) analysis. Moreover, the risk factors for ALN metastasis were evaluated. Results: Overall, the SUVmax was positively correlated with the number of metastatic ALN (p= 0.001). The mean SUVmax was higher in aggressive subtypes (4.5± 0.2, 6.1± 0.4, 6.5± 0.5, and 7.5± 0.5 in luminal A, luminal B, HER2+, and triple negative, respectively, p< 0.001). Upon ROC analysis, the SUVmax of the HER2+ subtype predicted ALN metastasis most accurately, with a cutoff value of 5.5, area under the curve (AUC) of 0.708, sensitivity of 74.2%, and specificity of 64.6% (p= 0.002). The triple negative subtype did not show a significant difference in SUVmax between patients with and without metastasis (p= 0.13). Subtype-adjusted SUVmax, HER2 positivity, lymphovascular invasion, and T stage were significant predictors for ALN metastasis. Conclusion: The SUVmax of primary breast cancer may be an independent predictor of ALN metastasis, being the most accurate in the HER2+ subtype. As PET/CT could facilitate tailored axillary management, this approach could be considered for the initial staging and treatment planning in patients with breast cancer.

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Section: Discussionmentioning

confidence: 92%

Predictive Value of the Standardized Uptake Value of 18F-fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in Assessing Axillary Lymph Node Metastasis in Different Subtypes of Breast Cancer

Kim

Choi

et al. 2019

J Breast Dis

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“…Cha et al 17 found that SUVmax of axillary nodes was higher in the Her2-positive group than either of the luminal groups, and Youm et al 18 showed higher values in TNBC than other subtypes. This correlation was not achieved (p = 0.061) in the present study.…”

Section: Discussionmentioning

confidence: 99%

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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“…And another study showed that tumor SUVmax could predict lymph node metastasis only in luminal A and HER2 positive type but not in luminal B and triple-negative type [15]. In contrast, the other study reported that PET-CT was a useful imaging tool in predicting lymph node metastasis in the triple-negative subtype compared to the other three subtypes, with a sensitivity of 87% and specificity of 67% [16].…”

Section: Discussionmentioning

confidence: 99%

The role of fluorodeoxyglucose-PET/computed tomography as a predictor of breast cancer characteristics and prognosis

Bae

Kim

Jung

et al. 2021

Nuclear Medicine Communications

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Purpose Fluorodeoxyglucose-PET/computed tomography (FDG-PET/CT) affects the management of patients with breast cancer. Our study aimed to determine the predictive ability of characteristics such as lymph node involvement or subtype and the prognostic value of pretreatment FDG-PET/CT in breast cancer.Method A total of 270 patients who were confirmed with breast cancer histopathologically and underwent pretreatment FDG-PET/CT were enrolled in the study. Nuclear medicine specialists obtained the readings and measured the maximum standardized uptake value (SUVmax) of the images. Tumor and lymph node SUVmax were evaluated according to lymph node metastasis and subtype status. Survival outcomes were analyzed by the Kaplan-Meier method. ResultsThe lymph node SUVmax and the lymph node/tumor SUVmax ratio were significantly higher in the subgroup of patients with lymph node metastasis than in those without lymph node metastasis. High cutoff lymph node SUVmax value and lymph node/tumor SUVmax ratio were confirmed as significant predictive factors in multivariate analysis. In a comparison of the tumor SUVmax values, the more biological aggressive subtype showed higher tumor SUVmax values. In survival analysis, tumor SUVmax and lymph node SUVmax were significant predisposing factors for disease-free survival in breast cancer. In subgroup analysis, tumor SUVmax was a more significant prognostic factor in patients who had breast cancer with tumor sizes of ≤2 cm. The lymph node SUVmax was more a significant prognostic factor in patients who had breast cancer with lymph node metastasis. ConclusionIn this study, we showed that the SUVmax of FDG-PET/CT was a useful predictor of lymph node metastasis and breast cancer prognosis. Nucl Med Commun 43: 108-113

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Use of positron emission tomography-computed tomography to predict axillary metastasis in patients with triple-negative breast cancer

Cited by 3 publications

References 30 publications

Predictive Value of the Standardized Uptake Value of 18F-fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in Assessing Axillary Lymph Node Metastasis in Different Subtypes of Breast Cancer

Predictive Value of the Standardized Uptake Value of 18F-fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in Assessing Axillary Lymph Node Metastasis in Different Subtypes of Breast Cancer

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

The role of fluorodeoxyglucose-PET/computed tomography as a predictor of breast cancer characteristics and prognosis

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