title: Glycolytic activity in breast cancer using 18F-FDG PET/CT as prognostic predictor: A molecular phenotype approach.
abstract: OBJECTIVE
  To explore the relationship between basal (18)F-FDG uptake in breast tumors and survival in patients with breast cancer (BC) using a molecular phenotype approach.
  
  
  METHODS
  This prospective and multicentre study included 193 women diagnosed with BC. All patients underwent an (18)F-FDG PET/CT prior to treatment. Maximum standardized uptake value (SUVmax) in tumor (T), lymph nodes (N), and the N/T index was obtained in all the cases. Metabolic stage was established. As regards biological prognostic parameters, tumors were classified into molecular sub-types and risk categories. Overall survival (OS) and disease free survival (DFS) were obtained. An analysis was performed on the relationship between semi-quantitative metabolic parameters with molecular phenotypes and risk categories. The effect of molecular sub-type and risk categories in prognosis was analyzed using Kaplan-Meier and univariate and multivariate tests.
  
  
  RESULTS
  Statistical differences were found in both SUVT and SUVN, according to the molecular sub-types and risk classifications, with higher semi-quantitative values in more biologically aggressive tumors. No statistical differences were observed with respect to the N/T index. Kaplan-Meier analysis revealed that risk categories were significantly related to DFS and OS. In the multivariate analysis, metabolic stage and risk phenotype showed a significant association with DFS.
  
  
  CONCLUSIONS
  High-risk phenotype category showed a worst prognosis with respect to the other categories with higher SUVmax in primary tumor and lymph nodes.
authors.affiliation: Nuclear Medicine Department, University General Hospital, Ciudad Real, Spain. Electronic address: angarvice@yahoo.es.
authors.forename: A M
authors.initials: AM
authors.lastname: Garcia Vicente
authors.affiliation: Nuclear Medicine Department, University General Hospital, Ciudad Real, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Soriano Castrejón
authors.affiliation: Department of Mathematics, University of Castilla-La Mancha, Ciudad Real, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Amo-Salas
authors.affiliation: Department of Mathematics, University of Castilla-La Mancha, Ciudad Real, Spain.
authors.forename: J F
authors.initials: JF
authors.lastname: Lopez Fidalgo
authors.affiliation: Oncology Department, Virgen de la Luz Hospital, Cuenca, Spain.
authors.forename: M M
authors.initials: MM
authors.lastname: Muñoz Sanchez
authors.affiliation: Oncology Department, Virgen de la Salud Hospital, Toledo, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Alvarez Cabellos
authors.affiliation: Oncology Department, La Mancha Centro Hospital, Alcázar de San Juan, Ciudad Real, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Espinosa Aunion
authors.affiliation: Surgery Department, Gómez Ulla Hospital, Madrid, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Muñoz Madero
mesh_terms: D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D053208:Kaplan-Meier Estimate; D064847:Multimodal Imaging; D010641:Phenotype; D000072078:Positron Emission Tomography Computed Tomography; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: (18)F-FDG PET/CT; (18)F-FDG PET/TC; Breast cancer; Cáncer de mama; Disease free status; Disease free survival; Estado libre de enfermedad; Fenotipos moleculares; Molecular phenotypes; Overall survival; Prognosis; Pronóstico; Supervivencia global; Supervivencia libre de enfermedad