title: Clinical significance of FDG-PET/CT at the postoperative surveillance in the breast cancer patients.
abstract: OBJECTIVE
  We evaluated the clinical role of [(18)F]-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) compared with conventional imaging (CI) to detect locoregional recurrence or distant metastasis during postoperative surveillance of patients with breast cancer.
  
  
  METHODS
  We included 1,819 examinations of 1,161 patients, who underwent FDG-PET/CT and CI, including mammography, breast ultrasound, whole-body bone scintigraphy, and chest radiography for postoperative surveillance. All patients had a history of surgery with or without adjuvant treatment due to more than stage II breast cancer between November 2003 and November 2009. We evaluated the diagnostic performance of CI, FDG-PET/CT, and combined CI and FDG-PET/CT for detecting locoregional recurrence, distant metastasis, and incidental cancer. We also analyzed false-positive and false-negative results in both FDG-PET/CT and CI.
  
  
  RESULTS
  Sensitivity, specificity, positive predictive value, and negative predictive value of CI were 75.4, 98.7, 93.4, and 94.3 %. Those of FDG-PET/CT were 97.5, 98.8, 95.4, and 99.4 %. Those of the combined results were 98.6, 98.2, 96.7, and 99.7 %. Sensitivity of FDG-PET/CT was significantly higher than that of CI (P < 0.05). Sensitivity of combined CI and FDG-PET/CT results improved, but they were not significantly different from those of FDG-PET/CT alone (P = 0.43). Seventeen false-positive and nine false-negative cases were detected with FDG-PET/CT, and 19 false-positive and 88 false-negative cases were detected with CI.
  
  
  CONCLUSIONS
  FDG-PET/CT is considered as an acceptable diagnostic imaging modality for postoperative surveillance of patients with breast cancer.
authors.affiliation: Departments of Radiology, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, Seoul, 137-040, Korea.
authors.forename: Na Young
authors.initials: NY
authors.lastname: Jung
authors.affiliation: Departments of Radiology, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, Seoul, 137-040, Korea. iryoo@catholic.ac.kr.
authors.forename: Ie Ryung
authors.initials: IR
authors.lastname: Yoo
authors.affiliation: Departments of Radiology, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, Seoul, 137-040, Korea.
authors.forename: Bong Joo
authors.initials: BJ
authors.lastname: Kang
authors.affiliation: Departments of Radiology, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, Seoul, 137-040, Korea.
authors.forename: Sung Hun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Surgery, The Catholic University of Korea, Seoul, Korea.
authors.forename: Byung Joo
authors.initials: BJ
authors.lastname: Chae
authors.affiliation: Departments of Radiology, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, Seoul, 137-040, Korea.
authors.forename: Ye Young
authors.initials: YY
authors.lastname: Seo
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D018567:Breast Neoplasms, Male / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D018275:Carcinoma, Lobular / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D018276:Carcinoma, Medullary / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008327:Mammography; D008875:Middle Aged; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D049268:Positron-Emission Tomography; D011182:Postoperative Care; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D016217:Ultrasonography, Mammary; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Breast cancer; FDG-PET/CT; Recurrence; Surveillance