Value of PET-FDG in primary breast cancer based on histopathological and immunohistochemical prognostic factors.
BACKGROUND
The aim of the study was to analyze in breast tumors the correlation between [(18)F]fluorodeoxyglucose (FDG) uptake assessed by positron emission tomography (PET) and histopathological and immunohistochemical prognostic factors.


METHODS
FDG-PET combined with computed tomography (CT) was performed before surgery in 45 women with biopsy-proven primary breast cancer. The standardized uptake value (SUV) was compared with histopathological findings after surgery.


RESULTS
A positive relationship was found between SUV and histological grade (p < 0.0001), histological type (p = 0.001), tumor size (p < 0.0435), estrogen receptor status (p < 0.0005), and progesterone receptor status (p = 0.002). FDG-PET/CT revealed unknown distant metastatic lesions in 2 of 12 patients with triple-negative breast cancer. The sensitivity of FDG-PET/CT for detecting axillary lymph node metastases was, respectively, 21% and 100% for pN1 and pN2 cases, whereas specificity was 100% for pN0.


CONCLUSIONS
SUV, a preoperative and noninvasive metabolic parameter, correlates with other known prognostic factors in breast cancer. This study provides valuable insight into the usefulness of FDG-PET/CT for preoperative staging of patients with triple-negative and poorly differentiated breast tumors but not for evaluating axillary lymph nodes and lobular carcinomas.
Heudel
Pierre
P
Department of Medical Oncology, Léon Bérard Cancer Center, 28 Rue Laennec, 69008 Lyon, France. pierreheudel@yahoo.fr
Cimarelli
Sebastien
S
Montella
Anthony
A
Bouteille
Catherine
C
Mognetti
Thomas
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011300:Preoperative Care; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
World J Surg. 2009 May;33(5):943-9
19259728
J Clin Oncol. 2004 Jan 15;22(2):277-85
14722036
Cancer. 2007 May 1;109(9):1721-8
17387718
Q J Nucl Med. 2001 Sep;45(3):257-68
11788818
Ann Surg Oncol. 1994 Mar;1(2):132-40
7834438
Eur J Nucl Med Mol Imaging. 2002 Oct;29(10):1317-23
12271413
Eur J Nucl Med Mol Imaging. 2008 Mar;35(3):475-83
17957366
J Nucl Med. 2005 Jul;46(7):1144-50
16000283
J Nucl Med. 1997 Aug;38(8):1186-91
9255146
Br J Surg. 2009 Feb;96(2):166-70
19160365
Clin Positron Imaging. 1999 Oct;2(5):261-271
14516650
J Cancer Res Clin Oncol. 2004 May;130(5):273-8
14986112
JAMA. 2006 Jun 7;295(21):2492-502
16757721
J Clin Oncol. 2002 Sep 1;20(17):3628-36
12202663
J Clin Oncol. 2002 Jan 15;20(2):379-87
11786564
Lancet. 2005 May 14-20;365(9472):1687-717
15894097
J Nucl Med. 2001 Jan;42(1):9-16
11197987
Ann Oncol. 2007 Mar;18(3):473-8
17164229
Cancer. 1998 Jun 1;82(11):2227-34
9610703
Cancer. 2008 Mar 1;112(5):995-1000
18098228
Eur J Nucl Med Mol Imaging. 2009 Oct;36(10):1543-50
19415270
J Clin Oncol. 2000 Oct 15;18(20):3495-502
11032590