title: Incidental Breast Lesions Identified by (18)F-FDG PET/CT: Which Clinical Variables Differentiate between Benign and Malignant Breast Lesions?
abstract: OBJECTIVE
  The aim of our study was to evaluate the risk of malignancy and to determine which clinical variables differentiate between benign and malignant focal breast lesions found incidentally on (18)F-flourodeoxyglucose positron emission tomography and computed tomography (FDG PET/CT).
  
  
  METHODS
  From March 2005 to October 2011, 21,224 women with no history of breast cancer underwent FDG PET/CT at three university-affiliated hospitals. We retrospectively identified 214 patients with incidental focal hypermetabolic breast lesions and grouped them into benign and malignant lesion groups. Of the 214 patients, 82 patients with 91 lesions were included in this study. All lesions were confirmed histologically or were assessed by follow-up imaging for greater than 2 years. The patient age, maximum standardized uptake value (SUVmax), lesion size on ultrasonography (US), and Breast Imaging-Reporting and Data System (BI-RADS) category on US in conjunction with mammography were compared between the groups. Multivariate logistic regression analysis was used to identify independent factors associated with malignancy.
  
  
  RESULTS
  The risk of malignancy was 29.7% (27/91) in breast incidentalomas detected by FDG PET/CT. The univariate analysis showed that the patient age, SUVmax, tumor size, and BI-RADS category differed significantly between the malignant and benign groups. The multivariate analysis showed that the BI-RADS category was the only significant factor differentiating benign from malignant lesions (p=0.002).
  
  
  CONCLUSIONS
  BIRADS category based on US in conjunction with mammography was the only useful tool to differentiate between malignant and benign lesions in breast incidentalomas on FDG PET/CT.
authors.affiliation: Department of Radiology, Kyungpook National University Medical Center, Daegu, Korea.
authors.forename: Kyung Min
authors.initials: KM
authors.lastname: Shin
authors.affiliation: Department of Radiology, Kyungpook National University Medical Center, Daegu, Korea.
authors.forename: Hye Jung
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Jung
authors.affiliation: Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
authors.forename: Hyo Soon
authors.initials: HS
authors.lastname: Lim
authors.affiliation: Department of Nuclear Medicine, Kyungpook National University Medical Center, Daegu, Korea.
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Department of Radiology, Kyungpook National University Medical Center, Daegu, Korea.
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Cho
authors.affiliation: Department of Radiology, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Yun-Jin
authors.initials: YJ
authors.lastname: Jang
authors.affiliation: Department of Radiology, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Hui Joong
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Radiology, Kyungpook National University Medical Center, Daegu, Korea.
authors.forename: Gab Chul
authors.initials: GC
authors.lastname: Kim
authors.affiliation: Departments of Surgery, Kyungpook National University Medical Center, Daegu, Korea.
authors.forename: Jin Hyang
authors.initials: JH
authors.lastname: Jung
authors.affiliation: Departments of Pathology, Kyungpook National University Medical Center, Daegu, Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Park
keywords: Breast neoplasms; Mammography; Positron-emission tomography; Ultrasonography
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