title: Changes in 18F-FDG tumor metabolism after a first course of neoadjuvant chemotherapy in breast cancer: influence of tumor subtypes.
abstract: BACKGROUND
  The aim of this study is to evaluate the impact of the different breast cancer subtypes on the tumor (18)F-FDG uptake at baseline and on its changes after the first course of neoadjuvant chemotherapy (NAC).
  
  
  METHODS
  One hundred and fifteen women with newly diagnosed, large or locally advanced breast cancer undergoing NAC were included. Estrogen receptor (ER), progesterone receptor (PR) and HER2 status were used to define three major tumor subtypes: triple negative (TN) (ER-/PR-/HER2-), luminal (ER+ and/or PR+; HER2-) and HER2 positive (HER2+). Using Fluorine-18 fluorodeoxyglucose positron emission tomography, the tumoral standard uptake value (SUV) maximal index was measured at baseline and just before the second course of NAC.
  
  
  RESULTS
  TN tumors presented the highest baseline SUV (11.3 ± 8.5; P < 0.0001). The decrease of SUV after the first course of NAC (ΔSUV) was significantly higher in TN and HER2-positive subtypes (-45% ± 25% and -57% ± 30%, respectively) than in luminal one (-19% ± 35%; P < 0.0001). ΔSUV was a predictive factor of the pathological complete response only in HER2-positive tumors (cut-off = -75%; P < 0.03) with an accuracy of 76%.
  
  
  CONCLUSIONS
  The baseline (18)F-FDG tumoral uptake but also its early response to NAC is different according to the immunohistological subtypes of breast cancer.
authors.affiliation: Departments of Nuclear Medicine, Dijon, France. Electronic address: ohumbert@cgfl.fr.
authors.forename: O
authors.initials: O
authors.lastname: Humbert
authors.affiliation: Departments of Nuclear Medicine, Dijon, France.
authors.forename: A
authors.initials: A
authors.lastname: Berriolo-Riedinger
authors.affiliation: Departments of Nuclear Medicine, Dijon, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Riedinger
authors.affiliation: Depertment of Medical Oncology, Dijon, France.
authors.forename: B
authors.initials: B
authors.lastname: Coudert
authors.affiliation: Pathology, Dijon, France.
authors.forename: L
authors.initials: L
authors.lastname: Arnould
authors.affiliation: Departments of Nuclear Medicine, Dijon, France; LE2I, UMR CNRS 5158, Université de Bourgogne, Dijon, France.
authors.forename: A
authors.initials: A
authors.lastname: Cochet
authors.affiliation: Surgery, Centre GF. Leclerc, Dijon, France.
authors.forename: C
authors.initials: C
authors.lastname: Loustalot
authors.affiliation: Depertment of Medical Oncology, Dijon, France; LE2I, UMR CNRS 5158, Université de Bourgogne, Dijon, France.
authors.forename: P
authors.initials: P
authors.lastname: Fumoleau
authors.affiliation: Departments of Nuclear Medicine, Dijon, France; LE2I, UMR CNRS 5158, Université de Bourgogne, Dijon, France.
authors.forename: F
authors.initials: F
authors.lastname: Brunotte
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000145:classification / Q000188:drug therapy* / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D006801:Humans; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D019788:Fluorodeoxyglucose F18