title: Preoperative PET/CT in early-stage breast cancer.
abstract: BACKGROUND
  The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer.
  
  
  METHODS
  A total of 103 consecutive patients with newly diagnosed operable breast cancer with tumors ≥2 cm were independently examined preoperatively with conventional assessment (mammography, breast/axillary ultrasound, chest X-ray and blood samples) and PET/CT with no prior knowledge of the other.
  
  
  RESULTS
  PET/CT identified a primary tumor in all but three patients (97%). PET/CT solely detected distant metastases (ovary, bones and lung) in 6 patients and new primary cancers (ovary, lung) in another two patients, as well as 12 cases of extra-axillary lymph node involvement. In 15 patients (15%), extra-axillary malignancy was detected by PET/CT only, leading to an upgrade of initial staging in 14% (14/103) and ultimately a modification of planned treatment in 8% (8/103) of patients.
  
  
  CONCLUSIONS
  PET/CT is a valuable tool to provide information on extra-axillary lymph node involvement, distant metastases and other occult primary cancers. Preoperative (18)F-fluorodeoxyglucose-PET/CT has a substantial impact on initial staging and on clinical management in patients with early-stage breast cancer with tumors ≥2 cm.
authors.affiliation: Departments of Oncology. Electronic address: mogenspetersen@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Bernsdorf
authors.affiliation: Departments of Clinical Physiology, Nuclear Medicine & PET.
authors.forename: A K
authors.initials: AK
authors.lastname: Berthelsen
authors.affiliation: Departments of Pathology.
authors.forename: V T
authors.initials: VT
authors.lastname: Wielenga
authors.affiliation: Departments of Breast Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen.
authors.forename: N
authors.initials: N
authors.lastname: Kroman
authors.affiliation: Departments of Breast Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen.
authors.forename: D
authors.initials: D
authors.lastname: Teilum
authors.affiliation: Departments of Clinical Physiology, Nuclear Medicine & PET; Cluster for Molecular imaging, Faculty of Health Sciences, University of Copenhagen, Copenhagen.
authors.forename: T
authors.initials: T
authors.lastname: Binderup
authors.affiliation: Departments of Oncology.
authors.forename: U B
authors.initials: UB
authors.lastname: Tange
authors.affiliation: Departments of Oncology.
authors.forename: M
authors.initials: M
authors.lastname: Andersson
authors.affiliation: Departments of Clinical Physiology, Nuclear Medicine & PET; Cluster for Molecular imaging, Faculty of Health Sciences, University of Copenhagen, Copenhagen.
authors.forename: A
authors.initials: A
authors.lastname: Kjær
authors.affiliation: Departments of Clinical Physiology, Nuclear Medicine & PET.
authors.forename: A
authors.initials: A
authors.lastname: Loft
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Hvidovre Hospital, University Hospital of Copenhagen, Copenhagen, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Graff
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011300:Preoperative Care; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18