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Diagnostic and prognostic correlates of preoperative FDG PET for breast cancer

Vinh-Hung, Vincent ; Everaert, Hendrik ; Lamote, Jan ; Voordeckers, Mia ; van Parijs, Hilde ; Vanhoeij, Marian ; Verfaillie, Guy ; Fontaine, Christel ; Vees, Hansjoerg ; Ratib, Osman ; Vlastos, Georges ; De Ridder, Mark

In: European Journal of Nuclear Medicine and Molecular Imaging, 2012, vol. 39, no. 10, p. 1618-1627

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    Title
    • Diagnostic and prognostic correlates of preoperative FDG PET for breast cancer
    Author
    • Vinh-Hung, Vincent. Department of Imaging and Medical Information Sciences, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
    • Everaert, Hendrik. Department of Nuclear Medicine, UZ Brussel, Vrije Universiteit Brussel, Jette, Brussels, Belgium
    • Lamote, Jan. Department of Surgery, UZ Brussel, Vrije Universiteit Brussel, Jette, Brussels, Belgium
    • Voordeckers, Mia. Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Jette, Brussels, Belgium
    • van Parijs, Hilde. Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Jette, Brussels, Belgium
    • Vanhoeij, Marian. Department of Surgery, UZ Brussel, Vrije Universiteit Brussel, Jette, Brussels, Belgium
    • Verfaillie, Guy. Department of Surgery, UZ Brussel, Vrije Universiteit Brussel, Jette, Brussels, Belgium
    • Fontaine, Christel. Department of Medical Oncology UZ Brussel, Vrije Universiteit Brussel, Jette, Brussels, Belgium
    • Vees, Hansjoerg. Department of Imaging and Medical Information Sciences, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
    • Ratib, Osman. Department of Imaging and Medical Information Sciences, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
    • Vlastos, Georges. Department of Surgical Senology, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
    • De Ridder, Mark. Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Jette, Brussels, Belgium
    Document Type
    • Postprint
    Language
    • English
    Published in
    • European Journal of Nuclear Medicine and Molecular Imaging, 2012, vol. 39, no. 10, p. 1618-1627. Springer-Verlag
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:318119
    Summary
    Purpose: To explore the preoperative utility of FDG PET for the diagnosis and prognosis in a retrospective breast cancer case series. Methods: In this retrospective study, 104 patients who had undergone a preoperative FDG PET scan for primary breast cancer at the UZ Brussel during the period 2002-2008 were identified. Selection criteria were: histological confirmation, FDG PET performed prior to therapy, and breast surgery integrated into the primary therapy plan. Patterns of increased metabolism were recorded according to the involved locations: breast, ipsilateral axillary region, internal mammary chain, or distant organs. The end-point for the survival analysis using Cox proportional hazards was disease-free survival. The contribution of prognostic factors was evaluated using the Akaike information criterion and the Nagelkerke index. Results: PET positivity was associated with age, gender, tumour location, tumour size >2 cm, lymphovascular invasion, oestrogen and progesterone receptor status. Among 63 patients with a negative axillary PET status, 56 (88.9%) had three or fewer involved nodes, whereas among 41 patients with a positive axillary PET status, 25 (61.0%) had more than three positive nodes (P < 0.0001). In the survival analysis of preoperative characteristics, PET axillary node positivity was the foremost statistically significant factor associated with decreased disease-free survival (hazard ratio 2.81, 95% CI 1.17-6.74). Conclusion: Preoperative PET axillary node positivity identified patients with a higher burden of nodal involvement, which might be important for treatment decisions in breast cancer patients