title: Detection of locoregional and distant recurrences in breast cancer patients by using FDG PET.
abstract: Cases of recurrence of breast cancer can pose considerable diagnostic and therapeutic challenges for the oncologic team. The prognosis and management decisions are based on knowledge of the true extent of disease. Conventional staging methods, including physical examination, assessment of levels of tumor markers, cross-sectional imaging, and bone scintigraphy, may not reliably demonstrate the extent of disease in all cases. Physical examination and cross-sectional imaging (computed tomography [CT] or magnetic resonance imaging) can be problematic because (a) the sequelae of previous surgery and radiation therapy can be difficult to distinguish from recurrent neoplasms and (b) early metastatic disease (small lesions) can be difficult to distinguish from benign lesions that are too small to characterize. Positron emission tomography (PET) with 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) can help clarify inconclusive findings from physical examination and cross-sectional imaging. FDG PET is more sensitive than CT in detection of lymphatic spread of disease to locoregional and mediastinal nodes. Metastases at distant sites including the lung, bone, and the liver are also readily detected at FDG PET. FDG PET has been proved accurate in restaging cases of recurrent breast cancer and will likely aid in directing therapy in these cases.
authors.affiliation: Department of Radiology (S-113-RAD), Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA 98108-1597, USA. weubank@u.washington.edu
authors.forename: William B
authors.initials: WB
authors.lastname: Eubank
authors.forename: David A
authors.initials: DA
authors.lastname: Mankoff
authors.forename: Hubert J
authors.initials: HJ
authors.lastname: Vesselle
authors.forename: Janet F
authors.initials: JF
authors.lastname: Eary
authors.forename: Erin K
authors.initials: EK
authors.lastname: Schubert
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Dunnwald
authors.forename: Skyler K
authors.initials: SK
authors.lastname: Lindsley
authors.forename: Julie R
authors.initials: JR
authors.lastname: Gralow
authors.forename: Mary M
authors.initials: MM
authors.lastname: Austin-Seymour
authors.forename: Georgianna K
authors.initials: GK
authors.lastname: Ellis
authors.forename: Robert B
authors.initials: RB
authors.lastname: Livingston
mesh_terms: D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18