Is [18F] fluorodeoxyglucose uptake by the primary tumor a prognostic factor in breast cancer?
BACKGROUND
We retrospectively investigated (18)F-FDG uptake by the primary breast tumor as a predictor for relapse and survival.


METHODS
We studied 203 patients with cT1-T3N0 breast cancer. Standardized uptake value (SUVmax), was measured on the primary tumor. After a median follow-up of 68 months (range 22-80), the relation between SUVmax and tumor factors, disease free-survival (DFS) and overall survival (OS) was investigated.


RESULTS
In the PET-positive patients, the median FDG uptake by the tumor was 4.7. FDG uptake was significantly related to tumor size, number of involved axillary nodes, grade, negative ER, high Ki-67 and HER2 overexpression. No distant metastases or deaths occurred in the PET-negative group. Five-year DFS was 97% and 83%, respectively in the PET-negative and PET-positive groups (P = 0.096). At univariate analysis, DFS was significantly lower in patients with SUVmax >4.7 compared to the patients with negative PET (P = 0.042), but not to the patients with SUVmax ≤4.7 (P = 0.106). At multivariable analysis, among PET-positive patients, SUVmax was not an independent prognostic factor for DFS (HR(>4.7 vs ≤4.7): 1.02 (95% CI 0.45-2.31)). Five-year OS was 100% and 93%, respectively, in the PET-negative and PET-positive groups (P = 0.126).


CONCLUSIONS
FDG uptake by the primary lesion was significantly associated with several prognostic variables, but it was not an independent prognostic factor.
Division of Nuclear Medicine, European Institute of Oncology, Milan, Italy. concetta.decicco@ieo.it
Concetta
C
De Cicco
Laura
L
Gilardi
Edoardo
E
Botteri
Silvia L V
SL
Fracassi
Giuseppina A
GA
Di Dia
Francesca
F
Botta
Gennaro
G
Prisco
Dario
D
Lombardo
Nicole
N
Rotmensz
Umberto
U
Veronesi
Giovanni
G
Paganelli
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D064847:Multimodal Imaging; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
D014408:Biomarkers, Tumor; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18