Upstaging of Invasive Lobular Cancer With FES PET/CT

Saud Rehman; Christine E Edmonds; David A Mankoff; Austin R Pantel; Sophia R O'Brien

doi:10.1097/RLU.0000000000005465

Upstaging of Invasive Lobular Cancer With FES PET/CT

Clin Nucl Med. 2024 Oct 10. doi: 10.1097/RLU.0000000000005465. Online ahead of print.

Authors

Saud Rehman¹, Christine E Edmonds², David A Mankoff², Austin R Pantel², Sophia R O'Brien²

Affiliations

¹ From the CUNY School of Medicine, New York, NY.
² Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA.

PMID: 39385362
DOI: 10.1097/RLU.0000000000005465

Abstract

A 78-year-old woman diagnosed with left breast invasive lobular carcinoma with left axillary nodal metastasis underwent 18 F-fluoroestradiol (FES) PET/CT imaging for further evaluation of indeterminate right axillary lymph nodes seen on staging 18 F-FDG PET/CT. 18 F-FES PET/CT revealed abnormal 18 F-FES-avid right axillary and bilateral cervical nodes, subsequently biopsy-proven metastases, upstaging the patient from stage II to IV and greatly changing patient management. This case demonstrates the value of 18 F-FES PET/CT in accurately staging metastatic invasive lobular carcinoma at diagnosis, an indication for which 18 F-FES PET/CT "may be appropriate" per current Society of Nuclear Medicine and Molecular Imaging guidelines.