Value of PET-FDG in primary breast cancer based on histopathological and immunohistochemical prognostic factors

Int J Clin Oncol. 2010 Dec;15(6):588-93. doi: 10.1007/s10147-010-0120-3. Epub 2010 Sep 1.

Abstract

Background: The aim of the study was to analyze in breast tumors the correlation between [(18)F]fluorodeoxyglucose (FDG) uptake assessed by positron emission tomography (PET) and histopathological and immunohistochemical prognostic factors.

Methods: FDG-PET combined with computed tomography (CT) was performed before surgery in 45 women with biopsy-proven primary breast cancer. The standardized uptake value (SUV) was compared with histopathological findings after surgery.

Results: A positive relationship was found between SUV and histological grade (p < 0.0001), histological type (p = 0.001), tumor size (p < 0.0435), estrogen receptor status (p < 0.0005), and progesterone receptor status (p = 0.002). FDG-PET/CT revealed unknown distant metastatic lesions in 2 of 12 patients with triple-negative breast cancer. The sensitivity of FDG-PET/CT for detecting axillary lymph node metastases was, respectively, 21% and 100% for pN1 and pN2 cases, whereas specificity was 100% for pN0.

Conclusion: SUV, a preoperative and noninvasive metabolic parameter, correlates with other known prognostic factors in breast cancer. This study provides valuable insight into the usefulness of FDG-PET/CT for preoperative staging of patients with triple-negative and poorly differentiated breast tumors but not for evaluating axillary lymph nodes and lobular carcinomas.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • Carcinoma, Ductal, Breast / diagnostic imaging*
  • Carcinoma, Ductal, Breast / metabolism
  • Carcinoma, Ductal, Breast / pathology
  • Carcinoma, Lobular / diagnostic imaging*
  • Carcinoma, Lobular / metabolism
  • Carcinoma, Lobular / pathology
  • Female
  • Fluorodeoxyglucose F18*
  • Follow-Up Studies
  • Humans
  • Immunoenzyme Techniques
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Positron-Emission Tomography*
  • Preoperative Care
  • Prospective Studies
  • Radiopharmaceuticals*
  • Survival Rate
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18