title: FDG-PET/CT detection of very early breast cancer in women with breast microcalcification lesions found in mammography screening.
abstract: BACKGROUND
  To assess the efficacy of positron emission tomography/computed tomography with the glucose analogue 2-[(18) F]fluoro-2-deoxy-D-glucose (FDG-PET/CT) in Taiwanese women with early breast cancer detected by mammography screening.
  
  
  METHODS
  Dual-time-point imaging of whole-body supine and breast prone scans using FDG-PET/CT were performed sequentially in the pre-operative stage.
  
  
  RESULTS
  A total of 11,849 patients underwent screening mammography, of whom 1,209 (10.2%) displayed positive results. After further investigation, 54 patients underwent FDG-PET/CT. Post-operative pathology examinations revealed malignancies in 26 lesions, including invasive breast cancer in 11 cases and non-invasive breast cancer in 15 cases, as well as benign disease in 30 lesions. The FDG-PET/CT findings from the whole-body scans were positive for 9 of 11 invasive breast cancers (81.8%) and 3 of 15 non-invasive cancers (20%), and they were negative for all benign lesions. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FDG-PET/CT with whole-body supine imaging were 46.2%, 100%, 100% and 68.2%, respectively. Breast prone imaging revealed another patient with ductal carcinoma in situ, increasing the sensitivity to 50%. Importantly, positive PET findings were significantly correlated with tumour histology (P = 0.006), tumour size (P = 0.039) and Ki-67 expression (P = 0.011).
  
  
  CONCLUSIONS
  FDG-PET/CT with whole-body scanning demonstrated high sensitivity to invasive breast cancer, limited sensitivity to non-invasive breast cancer, and high specificity for breast cancer. FDG-PET/CT might be useful for differentiating tumour invasiveness. However, the good PPV but poor NPV do not allow the physician to discard the biopsy.
authors: Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|National Yang-Ming University, School of Medicine, Taipei, Taiwan.
authors: Nan-Jing
authors: NJ
authors: Peng
authors: Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors: Chen-Pin
authors: CP
authors: Chou
authors: Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors: Huay-Ben
authors: HB
authors: Pan
authors: Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors: Tsung-Hsien
authors: TH
authors: Chang
authors: Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors: Chin
authors: C
authors: Hu
authors: Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors: Yu-Li
authors: YL
authors: Chiu
authors: Department of Pathology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors: Ting-Ying
authors: TY
authors: Fu
authors: National Yang-Ming University, School of Medicine, Taipei, Taiwan.|Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors: Hong-Tai
authors: HT
authors: Chang
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D002114:Calcinosis / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008875:Middle Aged; D064847:Multimodal Imaging / Q000706:statistics & numerical data; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D015995:Prevalence; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013624:Taiwan / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D051598:Whole Body Imaging / Q000706:statistics & numerical data
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: body CT; breast imaging; mammography; nuclear medicine; oncologic imaging