[Interests and perspectives of PET-CT for breast cancer: review of the literature].
18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is a technique of functional imaging whose interest in oncology does not cease growing. This article summarizes the results of the technique in senology. For the initial evaluation of locally advanced breast cancer (extended primitive lesion, axillary lymph nodes...), the FDG-PET makes it possible to evaluate lymph nodes (in particular internal mammary nodes) and to seek remote metastases. The sensitivity of the examination appears nevertheless low for the secondary lesions of small size and for bone metastases of osteoblastic form, for which the performances of the bisphosphonates scintigraphy are higher. For the search of a loco-regional or remote recurrence, the performances of FDG-PET are very interesting, including in the event of normality of the biological assessment. The impact of FDG-PET on the therapeutic strategy is undeniable and seems estimated at least 20%. FDG-PET is not recommended for the characterization of a breast lesion. In addition to the small tumoral size, the causes of false negative are mostly represented by the lobular histological form, by the tumours with low proliferation, the tumours of low grade and the well differentiated lesions. The causes of false positive are mainly in relation with inflammatory and/or infectious phenomena. For similar reasons, FDG-PET cannot replace the anatomy-pathological analysis of the axillary nodes. To evaluate the effectiveness of a neo-adjuvant chemotherapy, FDG-PET seems to be a powerful examination. Nevertheless, the data of the literature appear insufficient to recommend it in current practice. It is the same way for the prognostic interest.
Groheux
David
D
Service de médecine nucléaire et centre TEP, Hôpital Saint-Louis, Paris. dgroheux@yahoo.fr
Hindie
Elif
E
Espié
Marc
M
Toubert
Marie-Elisabeth
ME
Misset
Jean-Louis
JL
Giacchetti
Sylvie
S
Vercellino
Laetitia
L
Moretti
Jean-Luc
JL
D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18