title: Diagnostic and prognostic correlates of preoperative FDG PET for breast cancer.
abstract: OBJECTIVE
  To explore the preoperative utility of FDG PET for the diagnosis and prognosis in a retrospective breast cancer case series.
  
  
  METHODS
  In this retrospective study, 104 patients who had undergone a preoperative FDG PET scan for primary breast cancer at the UZ Brussel during the period 2002-2008 were identified. Selection criteria were: histological confirmation, FDG PET performed prior to therapy, and breast surgery integrated into the primary therapy plan. Patterns of increased metabolism were recorded according to the involved locations: breast, ipsilateral axillary region, internal mammary chain, or distant organs. The end-point for the survival analysis using Cox proportional hazards was disease-free survival. The contribution of prognostic factors was evaluated using the Akaike information criterion and the Nagelkerke index.
  
  
  RESULTS
  PET positivity was associated with age, gender, tumour location, tumour size >2 cm, lymphovascular invasion, oestrogen and progesterone receptor status. Among 63 patients with a negative axillary PET status, 56 (88.9 %) had three or fewer involved nodes, whereas among 41 patients with a positive axillary PET status, 25 (61.0 %) had more than three positive nodes (P < 0.0001). In the survival analysis of preoperative characteristics, PET axillary node positivity was the foremost statistically significant factor associated with decreased disease-free survival (hazard ratio 2.81, 95% CI 1.17-6.74).
  
  
  CONCLUSIONS
  Preoperative PET axillary node positivity identified patients with a higher burden of nodal involvement, which might be important for treatment decisions in breast cancer patients.
authors: Department of Imaging and Medical Information Sciences, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland. anhxang@gmail.com
authors: Vincent
authors: V
authors: Vinh-Hung
authors: Hendrik
authors: H
authors: Everaert
authors: Jan
authors: J
authors: Lamote
authors: Mia
authors: M
authors: Voordeckers
authors: Hilde
authors: H
authors: van Parijs
authors: Marian
authors: M
authors: Vanhoeij
authors: Guy
authors: G
authors: Verfaillie
authors: Christel
authors: C
authors: Fontaine
authors: Hansjoerg
authors: H
authors: Vees
authors: Osman
authors: O
authors: Ratib
authors: Georges
authors: G
authors: Vlastos
authors: Mark
authors: M
authors: De Ridder
mesh_terms: D000328:Adult; D018567:Breast Neoplasms, Male / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011300:Preoperative Care; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18