[The role of / 18FDG PET/CT for the initial staging and therapy in primary breast cancer].
OBJECTIVE
To evaluate the utility of / 18F-FDG PET/CT in the initial staging and predicting response to neoadjuvant chemotherapy ( NAC) for primary breast cancer.


METHODS
One hundred fourteen patients with primary breast cancer were preoperatively evaluated with PET/CT. The diagnostic value of PET/CT was compared in the final histopathology following surgery. Twenty patients also underwent PET/CT at baseline and after 4 and 8 courses of NAC. Changes (deltaSUV)in the maximum standard uptake value (SUVmax) between baseline study and after 4 or 8 courses of NAC were compared with the pathological response.


RESULTS
In the detection of primary breast cancer, PET/CT was 80. 7% sensitive, and especially, less sensitive in the detection of tumor size less than 10mm (66. 7%), low tumor grade (61. 3%), and ductal carcinoma in situ (50%). For axillary staging, PET/CT was 51. 9% sensitive and 95. 3% specific; in particular, it was less sensitive for small (<10mm) axillary lymph nodes (29. 4%) and could not detect micrometastasis. A cut-off deltaSUV value of 91. 9% was determined between baseline and after 4 courses of NAC differentiated responders(pathological CR)and non-responders, with a sensitivity of 80%, and a specificity of 78. 6% (p=0. 038).


CONCLUSIONS
Although PET/CT may have limited diagnostic value for detecting primary tumor and axillary staging, it is a valuable modality for monitoring the response to therapy.
Inokuchi
Masafumi
M
Dept. of Oncologic Surgery, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan.
Furukawa
Hiroyuki
H
Kayahara
Masato
M
Ohta
Tetsuo
T
Kawashima
Hiroko
H
Taki
Junichi
J
Kinuya
Seigo
S
D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18