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Impact of 18F-FDG PET on the management of recurrent breast cancer: a meta-analysis

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A Correction to this article was published on 10 May 2023

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Abstract

Purpose

The incidence of breast cancer has increased steadily. We performed a meta-analysis to assess the impact of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the management of breast cancer with respect to the detection of recurrence/metastasis after curative surgery.

Methods

We performed systematic searches of the MEDLINE and EMBASE databases for English language publications. All published studies regarding the impact of PET on the management of patients with breast cancer with respect to the detection of recurrence/metastasis after curative surgery, such as mastectomy or lumpectomy, were searched. The proportion of management change (%), defined as the percentage of patients for whom management was changed after FDG PET among patients who underwent FDG PET, was calculated.

Results

Thirteen studies, which included 982 patients, were included in this study. The impact of PET was evaluated based on the proportion of management change, and a pooled effect of 44.4% was noted. In the subgroup analyses for (1) equivocal/suspicious recurrence/metastasis on conventional imaging, (2) abnormal symptoms or physical examination, and (3) elevated tumor markers (n = 834), the pooled rate of management change was 45.9%. In patients with elevated tumor markers (n = 350) and in those who underwent PET for routine surveillance, the pooled rates of management change were 52.3% and 12.4%, respectively.

Conclusions

18F-FDG PET has a major impact on the management of patients with breast cancer after curative surgery. These findings suggest that 18F-FDG PET should be performed in patients with breast cancer in cases involving equivocal or suspicious recurrence/metastasis on conventional imaging or in cases involving elevated tumor markers during follow-up. However, this study does not support the routine use of 18F-FDG PET for surveillance in breast cancer.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital and School of Medicine, Pusan National University, Busan, Republic of Korea

    Kyoungjune Pak

  2. Department of Nuclear Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea

    Hai-Jeon Yoon

  3. Department of Surgery, College of Medicine, Ewha Womans University, Seoul, Republic of Korea

    Woosung Lim

  4. Department of Surgery and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea

    Hyun Yul Kim

Authors
  1. Kyoungjune Pak
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  4. Hyun Yul Kim
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Correspondence to Kyoungjune Pak or Hai-Jeon Yoon.

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The original online version of this article was revised: In this article the affiliation details for Kyoungjune Pak were incorrectly given. It should have been ‘Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital and School of Medicine, Pusan National University, Busan, Republic of Korea’.

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Pak, K., Yoon, HJ., Lim, W. et al. Impact of 18F-FDG PET on the management of recurrent breast cancer: a meta-analysis. Clin Transl Imaging 9, 255–263 (2021). https://doi.org/10.1007/s40336-021-00424-1

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  • DOI: https://doi.org/10.1007/s40336-021-00424-1

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