title: Monitoring of early response to neoadjuvant chemotherapy in stage II and III breast cancer by [18F]fluorodeoxyglucose positron emission tomography.
abstract: OBJECTIVE
  This study aimed to assess prospectively the efficacy of sequential [18F]fluorodeoxyglucose positron emission tomography (FDG PET) to evaluate early response to neoadjuvant chemotherapy in stage II and III breast cancer patients.
  
  
  METHODS
  Images were acquired with a PET/computed tomography scanner in 64 patients after administration of FDG (5 MBq/kg) at baseline and after the first, second, third, and sixth course of chemotherapy. Ultrasound and mammography were used to assess tumor size. Decrease in the standardized uptake value (SUV) with PET was compared with the pathologic response.
  
  
  RESULTS
  Surgery was performed after six courses of chemotherapy and pathologic analysis revealed gross residual disease in 28 patients and minimal residual disease in 36 patients. Although SUV data did not vary much in nonresponders (based on pathology findings), they decreased markedly to background levels in 94% (34 of 36) of responders. When using 60% of SUV at baseline as the cutoff value, the sensitivity, specificity, and negative predictive value of FDG PET were 61%, 96%, and 68% after one course of chemotherapy, 89%, 95%, and 85% after two courses, and 88%, 73%, and 83% after three courses, respectively. The same parameters with ultrasound (US) and mammography were 64%, 43%, and 55%, and 31%, 56%, and 45%, respectively. Assessment of tumor response with US or mammography was never significant whatever the cutoff.
  
  
  CONCLUSIONS
  Pathologic response to neoadjuvant chemotherapy in stage II and III breast cancer can be predicted accurately by FDG PET after two courses of chemotherapy.
authors.affiliation: Nuclear Medicine Unit, René Gauducheau Cancer Center, Saint Herblain, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Rousseau
authors.forename: Anne
authors.initials: A
authors.lastname: Devillers
authors.forename: Christine
authors.initials: C
authors.lastname: Sagan
authors.forename: Ludovic
authors.initials: L
authors.lastname: Ferrer
authors.forename: Boumédiène
authors.initials: B
authors.lastname: Bridji
authors.forename: Loïc
authors.initials: L
authors.lastname: Campion
authors.forename: Myriam
authors.initials: M
authors.lastname: Ricaud
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Bourbouloux
authors.forename: Isabelle
authors.initials: I
authors.lastname: Doutriaux
authors.forename: Martine
authors.initials: M
authors.lastname: Clouet
authors.forename: Dominique
authors.initials: D
authors.lastname: Berton-Rigaud
authors.forename: Catherine
authors.initials: C
authors.lastname: Bouriel
authors.forename: Valérie
authors.initials: V
authors.lastname: Delecroix
authors.forename: Etienne
authors.initials: E
authors.lastname: Garin
authors.forename: Sophie
authors.initials: S
authors.lastname: Rouquette
authors.forename: Isabelle
authors.initials: I
authors.lastname: Resche
authors.forename: Pierre
authors.initials: P
authors.lastname: Kerbrat
authors.forename: Jean François
authors.initials: JF
authors.lastname: Chatal
authors.forename: Mario
authors.initials: M
authors.lastname: Campone
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D000069287:Capecitabine; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077143:Docetaxel; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011292:Premedication; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012074:Remission Induction; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D015251:Epirubicin; D000069287:Capecitabine; D003520:Cyclophosphamide; D005472:Fluorouracil