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Comparison of FDG PET and MRI for evaluating the tumor extent of breast cancer and the impact of FDG PET on the systemic staging and prognosis of patients who are candidates for breast-conserving therapy

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Abstract

Background

FDG PET has not yet found a role in the clinical evaluation of the tumor extent of breast cancer. FDG PET has been reported to be useful for evaluating the prognoses of breast cancer patients with more accuracy than conventional imaging modalities. The purpose of this study was to compare the accuracy of FDG PET and MRI for the preoperative assessment of the tumor extent of breast cancer, for evaluating the impact of FDG PET on systemic staging, and also for predicting the prognosis of patients who are candidates for breast-conserving therapy.

Methods

The study was a prospective series of 23 breasts with breast cancer that underwent both FDG PET and MRI before surgery. Systemic staging with FDG PET was also performed. The correlation between the results of these examinations and histological findings was thus examined. The maximum standardized uptake value (SUVmax) of the tumors was investigated in association with the patient prognoses.

Results

When evaluating the local tumor extent, the accuracy of FDG PET (43.5%) was significantly lower than that of MRI (91%) (P < 0.001). The sensitivity, specificity, and accuracy of FDG PET regarding the nodal status were 60, 94, and 87%, respectively. No patients demonstrated any distant metastasis, whereas FDG PET gave a false positive in one patient. The mean follow-up period was 61 months. The SUVmax value of the worse prognosis patient group was significantly higher than that of the good prognosis patient group (P = 0.032).

Conclusions

FDG PET is not a breast imaging modality for evaluating the local tumor extent, but it is useful for predicting the prognoses of patients who are candidates for breast-conserving therapy.

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References

  1. NIH Consensus Conference. Treatment of early-stage breast cancer. J Am Med Assoc. 1991;265:391–5.

    Google Scholar 

  2. Vicini FA, Eberlein TL, Connolly JL, Recht A, Abner A, Schnitt SJ, et al. The optimal extent of resection for patients with stages 1 or 2 breast cancer treated with conservative surgery and radiotherapy. Ann Sur. 1991;214:200–4.

    Article  CAS  Google Scholar 

  3. Smitt MC, Nowels KW, Zdeblick MJ, Jeffrey S, Carlson RW, Stockdale FE, et al. The importance of the lumpectomy surgical margin status in long term results of breast conservation. Cancer. 1995;76:259–67.

    Article  PubMed  CAS  Google Scholar 

  4. Gage I, Schnitt SJ, Nixon AJ, Silver B, Recht A, Troyan SL, et al. Pathologic margin involvement and the risk of recurrence in patients treated with breast-conserving therapy. Cancer. 1996;78:1921–8.

    Article  PubMed  CAS  Google Scholar 

  5. Connolly JL, Boyages J, Nixon AJ, Peiro G, Silver B, Recht A, et al. Predictors of breast recurrence after conservative surgery and radiation therapy for invasive breast cancer. Mod Pathol. 1998;11:134–9.

    PubMed  CAS  Google Scholar 

  6. Uematsu T, Yuen S, Kasami M, Uchida Y. Comparison of magnetic resonance imaging, multidetector row computed tomography, ultrasonography, and mammography for tumor extension of breast cancer. Breast Cancer Res Treat 2008; Epub ahead of print.

  7. Avril N, Adler LP. F-18 fluorodeoxyglucose-positron emission tomography imaging for primary breast cancer and loco-regional staging. Radiol Clin North Am. 2007;45:645–57.

    Article  PubMed  Google Scholar 

  8. Avril N, Rose CA, Schelling M, Dose J, Kuhn W, Bense S, et al. Breast imaging with positron emission tomography and fluorine-18 fluorodeoxyglucose: use and limitations. J Clin Oncol. 2000;18:3495–502.

    PubMed  CAS  Google Scholar 

  9. Schirrmeister H, Kuhn T, Guhlmann A, Santjohaser C, Horster T, Nuessle K, et al. Fluorine-18 2-deoxy-2 fluoro-D-glucose PET in the preoperative staging of breast cancer: comparison with the standard staging procedures. Eur J Nucl Med. 2001;28:351–8.

    Google Scholar 

  10. Rieber A, Schirrmeister H, Gabelmann A, Nuessle K, Reske S, Kreienberg R, et al. Pre-operative staging of invasive breast cancer with MR mammography and/or PET: boon or bunk? Br J Radiol. 2002;75:789–98.

    PubMed  CAS  Google Scholar 

  11. Heinisch M, Gallowitsch HJ, Mikosch P, Kresnik E, Kumnig G, Gomez I, et al. Comparison of FDG-PET and dynamic contrast-enhanced MRI in the evaluation of suggestive breast lesions. Breast. 2003;12:17–22.

    Article  PubMed  CAS  Google Scholar 

  12. Oshida M, Uno K, Suzuki M, Nagashima T, Hashimoto H, Yagata H, et al. Predicting the prognoses of breast carcinoma patients with positron emission tomography using 2-deoxy-2-fluoro[18F]-D-glucose. Cancer. 1998;82:2227–34.

    Google Scholar 

  13. Inoue T, Yutani K, Taguchi T, Tamaki Y, Shiba E, Noguchi S. Preoperative evaluation of prognosis in breast cancer patients by [18F]2-deoxy-2-fluoro-D-glucose-positron emission tomography. J Cancer Res Clin Oncol. 2004;130:273–8.

    Google Scholar 

  14. Cermik TF, Mavi A, Basu S, Alavi A. Impact of FDG PET on the preoperative staging of newly diagnosed breast cancer. Eur J Nucl Med Mol Imaging 2007;35(3):475–83.

    Google Scholar 

  15. American College of Radiology. Breast imaging reporting and data system (BI-RADS), 4th ed. American College of Radiology, Reston; 2003.

  16. Berg WA, Gutierrez L, NessAiver MS, Carter WB, Bhargavan M, Lewis RS, et al. Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology. 2004;233:830–49.

    Article  PubMed  Google Scholar 

  17. Uematsu T, Sano M, Homma K, Sato N. Comparison between high-resolution helical CT and pathology in breast examination. Acta Radiol. 2002;43:385–90.

    Article  PubMed  CAS  Google Scholar 

  18. Egan RL. Multicentric breast carcinomas: clinical-radiographic–pathologic whole organ studies and 10-year survival. Cancer. 1982;49:1123–30.

    Article  PubMed  CAS  Google Scholar 

  19. Faverly DRG, Hendriks JHCL, Holland R. Breast carcinomas of limited extend. Cancer. 2001;91:647–59.

    Article  PubMed  CAS  Google Scholar 

  20. Vranjesevic D, Schiepers C, Silverman DH, Quon A, Villalpando J, Dahlbom M, et al. Relationship between 18F-FDG uptake and breast density in women with normal breast tissue. J Nucl Med. 2003;44:1238–42.

    PubMed  Google Scholar 

  21. Tse NY, Hoh CK, Hawkins RA, Zinner MJ, Dahlbom M, Choi Y, Maddahi J, Brunicardi FC, Phelps ME, Glaspy. The application of positron emission tomographic imaging with fluorodeoxyglucose to the evaluation of breast disease. Ann Surg. 1992;216:27–34.

  22. Crippa F, Seregni E, Agresti R, Chiesa C, Bogri A, Decise D, et al. Association between F-18 fluorodeoxyglucose uptake and postoperative histopathology, hormone receptor status, thymidine labeling index and p53 in primary breast cancer: a preliminary observation. Eur J Nucl Med. 1998;25:1429–34.

    Article  PubMed  CAS  Google Scholar 

  23. Avril N, Menzel M, Dose J, Schelling M, Weber W, Janicke F, et al. Glucose metabolism of breast cancer assessed by 18F-FDG PET: histologic and immunohistochemical tissue analysis. J Nucl Med. 2001;42:9–16.

    PubMed  CAS  Google Scholar 

  24. Wahl RL, Siegel BA, Coleman E, Gatsonis CG. Prospective multicenter study of axillary nodal staging by positron emission tomography in breast cancer: a report of the staging breast cancer with PET study group. J Clin Oncol. 2004;22:277–85.

    Article  PubMed  Google Scholar 

  25. Lovrics PJ, Chen V, Coates G, Cornacchi SD, Goldsmith CH, Law C, et al. A prospective evaluation of positron emission tomography scanning sentinel lymph node biopsy, and standard axillary dissection for axillary staging in patients with early stage breast cancer. Ann Surg Oncol. 2004;11:846–53.

    Article  PubMed  Google Scholar 

  26. Barranger E, Grahek D, Antoine M, Montravers F, Talbot JN, Uzan S. Evaluation of fluorodeoxyglucose positron emission tomography in the detection of axillary lymph node metastases in patients with early-stage breast cancer. Ann Surg Oncol. 2004;10:622–7.

    Article  Google Scholar 

  27. Eubank WB, Mankoff D, Bhattacharya M, Gralow J, Linden H, Ellis G, et al. Impact of FDG PET on defining the extent of disease and on the treatment of patients with recurrent or metastatic breast cancer. Am J Roentgenol. 2004;183:479–86.

    Google Scholar 

  28. Vranjesevic D, Filmont JE, Meta J, Silverman DH, Phelps ME, Rao J, et al. Whole-body (18) F-FDG PET and conventional imaging for predicting outcome in previously treated breast cancer patients. J Nucl Med. 2002;43:325–9.

    PubMed  Google Scholar 

  29. Monn DH, Maddahi J, Silverman DH, Glaspy JA, Phelps ME, Hoh CK. Accuracy of whole-body fluorine-18-FDG PET for the detection of recurrent or metastatic breast carcinoma. J Nucl Med. 1998;39:431–5.

    Google Scholar 

  30. Basu S, Chen W, Tchou J, Mavi A, Cermik T, Czerniecki B, et al. Comparison of triple-negative and estrogen receptor-positive/progesterone receptor-positive/HER2-negative breast carcinoma using quantitative fluorine-18 fluorodeoxyglucose/positron emission tomography imaging parameters. Cancer. 2008;112:995–1000.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Breast Imaging and Breast Intervention, Breast Center, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan

    Takayoshi Uematsu & Sachiko Yuen

  2. Department of Pathology, Shizuoka Cancer Center Hospital, Shizuoka, Japan

    Masako Kasami

  3. Department of Clinical Physiology, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan

    Takayoshi Uematsu

Authors
  1. Takayoshi Uematsu
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  2. Masako Kasami
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  3. Sachiko Yuen
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Correspondence to Takayoshi Uematsu.

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Uematsu, T., Kasami, M. & Yuen, S. Comparison of FDG PET and MRI for evaluating the tumor extent of breast cancer and the impact of FDG PET on the systemic staging and prognosis of patients who are candidates for breast-conserving therapy. Breast Cancer 16, 97–104 (2009). https://doi.org/10.1007/s12282-008-0065-9

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  • DOI: https://doi.org/10.1007/s12282-008-0065-9

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