title: Relation between primary tumor FDG avidity and site of first distant metastasis in patients with breast cancer.
abstract: Identification of tumor imaging features associated with metastatic pattern may allow better understanding of cancer dissemination. Here, we investigated how primary tumor F-fluorodeoxyglucose (FDG) avidity influences the first site of breast cancer metastasis.Subjects were 264 patients with advanced breast cancer who underwent positron emission tomography/computed tomography at diagnosis and had metastasis at presentation (n = 193) or metastatic relapse after surgery (n = 71). Primary tumor FDG avidity (maximum SUV [SUVmax] ≥10.1) was compared with histology and first metastatic sites.The most common site of first metastasis was the bone, occurring in 62.7% of patients with metastasis at presentation and 38.0% of those with metastatic relapse. First metastasis to lung occurred in 30.1% and 35.2%, and to liver in 25.4% and 15.2% of respective groups. In patients with metastasis at presentation, primary tumors were FDG avid in 98/193 cases, and this was associated with more frequent first metastasis to lung (37.8% vs 22.1%; P = 0.018). In patients with metastasis relapse, primary tumors were FDG avid in 31/71 cases, and this was associated with more frequent first metastasis to lung (48.4% vs 25.0%; P = 0.041) and liver (29.0% vs 5.0%; P = 0.008). In patients with metastasis relapse, primary tumors that were FDG avid but hormone receptor negative had more first metastasis to lung (57.9% vs 26.9%; P = 0.016).FDG-avid primary breast tumors have favored first spread to the lung and liver, which suggests that tumor cells with heightened glycolytic activity better colonize these organs.
authors: Department of Nuclear Medicine Department of Internal Medicine, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Chae Hong
authors: CH
authors: Lim
authors: Seung Hwan
authors: SH
authors: Moon
authors: Young Seok
authors: YS
authors: Cho
authors: Young-Hyuck
authors: YH
authors: Im
authors: Yearn Seong
authors: YS
authors: Choe
authors: Byung-Tae
authors: BT
authors: Kim
authors: Kyung-Han
authors: KH
authors: Lee
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D016009:Chi-Square Distribution; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011379:Prognosis; D012680:Sensitivity and Specificity; D015996:Survival Rate
chemical_list: D019788:Fluorodeoxyglucose F18