title: Defining the role of PET-CT in staging early breast cancer.
abstract: BACKGROUND
  Currently, there is a lack of data on the role of combined positron emission tomography-computed tomography (PET-CT) in the staging of early invasive primary breast cancer. We therefore evaluated the role of (18)F-fluorodeoxyglucose ((18)F-FDG)-PET-CT in this patient population.
  
  
  METHODS
  We prospectively recruited 70 consecutive patients (69 women, one man; mean age, 61.9 ± 8.1 years) with early primary breast cancer for staging with (18)F-FDG-PET-CT. All PET-CT images were interpreted by two readers (independently of each other). A third reader adjudicated any discrepancies. All readers had ≥5 years of specific experience. Ethics board approval and informed consent were obtained.
  
  
  RESULTS
  The mean clinical follow-up was 22.7 ± 12.6 months. The primary tumor was identified with PET-CT in 64 of 70 patients. Of the unidentified lesions, surgical pathology revealed two intraductal carcinomas, one invasive tubular carcinoma, and three invasive lobular carcinomas. Undiagnosed multifocal breast disease was shown in seven of 70 patients. PET-CT identified avid axillary lymph nodes in 19 of 70 patients, compared with 24 of 70 confirmed during surgery. There were four patients who were axillary node positive on PET but had no axillary disease at surgery. Five patients were reported with avid metastases. Two of those patients were treated for metastatic disease (nodal, lung, and liver in one and bone metastases in the other) following further imaging and clinical assessment. In the other three patients, lesions (lung, n = 1; pleural, n = 1; paratrachael node, n = 1) were subsequently diagnosed as benign lesions.
  
  
  CONCLUSIONS
  Integrated (18)F-FDG-PET-CT may have a role in staging patients presenting with early breast cancer.
authors.affiliation: Institute of Nuclear Medicine, University College London, London, United Kingdom. drashleygroves@hotmail.com
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Groves
authors.forename: Manu
authors.initials: M
authors.lastname: Shastry
authors.forename: Simona
authors.initials: S
authors.lastname: Ben-Haim
authors.forename: Irfan
authors.initials: I
authors.lastname: Kayani
authors.forename: Anmol
authors.initials: A
authors.lastname: Malhotra
authors.forename: Timothy
authors.initials: T
authors.lastname: Davidson
authors.forename: Tina
authors.initials: T
authors.lastname: Kelleher
authors.forename: Diane
authors.initials: D
authors.lastname: Whittaker
authors.forename: Marie
authors.initials: M
authors.lastname: Meagher
authors.forename: Brian
authors.initials: B
authors.lastname: Holloway
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Warren
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Ell
authors.forename: Mohammed R
authors.initials: MR
authors.lastname: Keshtgar
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18