The value of 18F-FDG PET/CT imaging in breast cancer staging

Ulkem Yararbas; Neslihan Cetin Avci; Levent Yeniay; Aziz Murat Argon

doi:10.17305/bjbms.2017.2179

Authors

Ulkem Yararbas Department of Nuclear Medicine, Ege University Medical Faculty, Izmir, Turkey
Neslihan Cetin Avci Department of Nuclear Medicine, Umraniye Training and Research Hospital, Istanbul, Turkey
Levent Yeniay Department of General Surgery, Ege University Medical Faculty, Izmir, Turkey
Aziz Murat Argon Department of Nuclear Medicine, Ege University Medical Faculty, Izmir, Turkey

DOI:

https://doi.org/10.17305/bjbms.2017.2179

Keywords:

Breast cancer, Breast cancer staging, 18F-FDG, 18F-FDG PET/CT

Abstract

The National Comprehensive Cancer Network (NCCN) guidelines recommend assessment with positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose integrated with computed tomography (¹⁸F-FDG PET/CT) in staging of breast cancer, starting from the stage IIIA. Previously, PET/CT contributed to the accurate staging from the stage IIB. Our aim is to evaluate the contribution of ¹⁸F-FDG PET/CT in staging of breast cancer patients. A total of 234 patients were retrospectively evaluated. PET/CT was performed preoperatively in 114/234 and postoperatively in 120/234 patients. Initial staging was performed based on histopathological results in 125/234 and clinical results in 109/234 patients, according to the American Joint Committee on Cancer (AJCC) classification. All patients had a normal abdominal ultrasound and chest x-ray. Following PET/CT imaging, modification in the staging was performed in patients with the metastatic findings. In 42/234 (17.9%) patients hypermetabolic extra-axillary regional lymph nodes and in 65/234 patients (27.7%) distant metastatic involvement were detected with PET/CT. Modification in the staging was applied in 82/234 (35%) patients. Patient management was changed in 69/234 (29.4%) cases. The percentage of patients with upstaging, according to each stage, was as follows: IIA: 18.6%, IIB: 30%, IIIA: 46.3%, IIIB: 68.8%, and IIIC: 20.8%. In 43/43 patients, ^99mTc-methylene diphosphonate (MDP) bone scan did not show additional bone metastasis. In 5/32 patients, metastatic involvement was detected with sentinel lymph node biopsy (SLNB), but preoperative PET/CT scan did not reveal hypermetabolic lymph nodes. Although our study was limited by the referral bias and lack of homogeneity in the referral group, PET/CT still significantly contributed to the accurate staging and management of our breast cancer patients, starting from the stage IIA.

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Author Biographies

Ulkem Yararbas, Department of Nuclear Medicine, Ege University Medical Faculty, Izmir, Turkey

Department of Nuclear Medicine
Neslihan Cetin Avci, Department of Nuclear Medicine, Umraniye Training and Research Hospital, Istanbul, Turkey

Department of Nuclear Medicine
Levent Yeniay, Department of General Surgery, Ege University Medical Faculty, Izmir, Turkey

Department of General Surgery
Aziz Murat Argon, Department of Nuclear Medicine, Ege University Medical Faculty, Izmir, Turkey

Department of Nuclear Medicine

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