title: Temporal Heterogeneity of Estrogen Receptor Expression in Bone-Dominant Breast Cancer: 18F-Fluoroestradiol PET Imaging Shows Return of ER Expression.
abstract: Changes in estrogen receptor (ER) expression over the course of therapy may affect response to endocrine therapy. However, measuring temporal changes in ER expression requires serial biopsies, which are impractical and poorly tolerated by most patients. Functional ER imaging using (18)F-fluoroestradiol (FES)-PET provides a noninvasive measure of regional ER expression and is ideally suited to serial studies. Additionally, lack of measurable FES uptake in metastatic sites of disease predict tumor progression in patients with ER-positive primary tumors treated with endocrine therapy. This report presents a case of restored sensitivity to endocrine therapy in a patient with bone-dominant breast cancer who underwent serial observational FES-PET imaging over the course of several treatments at our center, demonstrating the temporal heterogeneity of regional ER expression. Although loss and restoration of endocrine sensitivity in patients who have undergone prior hormonal and cytotoxic treatments has been reported, this is, to our knowledge, the first time the accompanying changes in ER expression have been documented by molecular imaging.
authors: University of Washington/Seattle Cancer Care Alliance, Seattle, Washington
authors: Erin
authors: E
authors: Currin
authors: University of Washington/Seattle Cancer Care Alliance, Seattle, Washington
authors: Lanell M
authors: LM
authors: Peterson
authors: University of Pennsylvania, Philadelphia, Pennsylvania
authors: Erin K
authors: EK
authors: Schubert
authors: Oregon Health and Science University, Portland, Oregon
authors: Jeanne M
authors: JM
authors: Link
authors: University of Washington/Seattle Cancer Care Alliance, Seattle, Washington
authors: Kenneth A
authors: KA
authors: Krohn
authors: University of Arizona, Tucson, Arizona
authors: Robert B
authors: RB
authors: Livingston
authors: University of Pennsylvania, Philadelphia, Pennsylvania
authors: David A
authors: DA
authors: Mankoff
authors: University of Washington/Seattle Cancer Care Alliance, Seattle, Washington
authors: Hannah M
authors: HM
authors: Linden
mesh_terms: D001859:Bone Neoplasms / Q000378:metabolism / Q000473:pathology; D001842:Bone and Bones / Q000378:metabolism* / Q000473:pathology*; D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D057054:Molecular Imaging / Q000379:methods; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D011960:Receptors, Estrogen / Q000378:metabolism*
chemical_list: D019275:Radiopharmaceuticals; D011960:Receptors, Estrogen