title: Triple-negative breast cancer: early assessment with 18F-FDG PET/CT during neoadjuvant chemotherapy identifies patients who are unlikely to achieve a pathologic complete response and are at a high risk of early relapse.
abstract: Triple-negative breast cancer, an aggressive subtype, represents 15% of invasive breast tumors. This prospective study investigated whether early changes in (18)F-FDG tumor uptake during neoadjuvant chemotherapy (NAC) can predict outcomes.
  
  
  METHODS
  Twenty (M0) patients underwent (18)F-FDG PET/CT at baseline and after the second cycle. NAC was continued irrespective of PET results.
  
  
  RESULTS
  At surgery, 6 patients had a pathologic complete response, whereas 14 had residual tumor. Four patients showed early relapse (in the 2 y after surgery). There were 11 metabolic responders and 9 nonresponders using a 42% decrease in maximum standardized uptake value as a cutoff. In nonresponding patients, the risk of residual tumor at surgery was 100% (vs. 45% in responders; P = 0.014), and the risk of early relapse was 44% (vs. 0%; P = 0.024).
  
  
  CONCLUSIONS
  A less than 42% decrease in (18)F-FDG uptake at 2 cycles means residual tumor at the end of NAC and a high risk of early relapse.
authors.affiliation: Department of Nuclear Medicine, Saint-Louis Hospital, Paris, France. dgroheux@yahoo.fr
authors.forename: David
authors.initials: D
authors.lastname: Groheux
authors.forename: Elif
authors.initials: E
authors.lastname: Hindié
authors.forename: Sylvie
authors.initials: S
authors.lastname: Giacchetti
authors.forename: Marc
authors.initials: M
authors.lastname: Delord
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Hamy
authors.forename: Anne
authors.initials: A
authors.lastname: de Roquancourt
authors.forename: Laetitia
authors.initials: L
authors.lastname: Vercellino
authors.forename: Nathalie
authors.initials: N
authors.lastname: Berenger
authors.forename: Michel
authors.initials: M
authors.lastname: Marty
authors.forename: Marc
authors.initials: M
authors.lastname: Espié
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging; D020360:Neoadjuvant Therapy; D018579:Patient Selection; D049268:Positron-Emission Tomography; D012008:Recurrence; D012306:Risk; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18