title: Initial staging impact of fluorodeoxyglucose positron emission tomography/computed tomography in locally advanced breast cancer.
abstract: OBJECTIVE
  Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) may reveal distant metastases more accurately than conventional imaging (CT, skeletal scintigraphy, chest radiography). We hypothesized that patients diagnosed with stage III noninflammatory breast cancer (non-IBC) and IBC by conventional imaging with PET/CT have a better prognosis than patients diagnosed without PET/CT.
  
  
  METHODS
  We retrospectively identified 935 patients with stage III breast cancer in 2000-2009. We compared the relapse-free survival (RFS) and overall survival (OS) times of patients diagnosed by conventional imaging with those of patients diagnosed by conventional imaging plus PET/CT. Univariate and multivariate Cox proportional hazards regression models were used to assess associations between survival and PET/CT.
  
  
  RESULTS
  RFS and OS times were not significantly different between patients imaged with PET/CT and those imaged without PET/CT. However, the RFS time in IBC patients was significantly different between patients imaged with PET/CT and those imaged without PET/CT on both univariate (hazard ratio [HR], 0.43; p = .014) and multivariate (HR, 0.33; p = .004) analysis. There was a trend for a longer OS duration in IBC patients imaged with PET/CT.
  
  
  CONCLUSIONS
  Among IBC patients, adding PET/CT to staging based on conventional imaging might detect patients with metastases that were not detected by conventional imaging. The use of conventional imaging with PET/CT for staging in non-IBC patients is not justified on the basis of these retrospective data. The use of conventional imaging plus PET/CT in staging IBC needs to be studied prospectively to determine whether it will improve prognosis.
authors.affiliation: Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Naoki
authors.initials: N
authors.lastname: Niikura
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Costelloe
authors.forename: Shana L
authors.initials: SL
authors.lastname: Palla
authors.forename: John E
authors.initials: JE
authors.lastname: Madewell
authors.forename: Naoki
authors.initials: N
authors.lastname: Hayashi
authors.forename: Tse-Kuan
authors.initials: TK
authors.lastname: Yu
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tokuda
authors.forename: Richard L
authors.initials: RL
authors.lastname: Theriault
authors.forename: Gabriel N
authors.initials: GN
authors.lastname: Hortobagyi
authors.forename: Naoto T
authors.initials: NT
authors.lastname: Ueno
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D058922:Inflammatory Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019788:Fluorodeoxyglucose F18