European Journal of Nuclear Medicine and Molecular Imaging

, Volume 38, Issue 2, pp 293–301

Tumour markers and FDG PET/CT for prediction of disease relapse in patients with breast cancer

  • Laura Evangelista
  • Zora Baretta
  • Lorenzo Vinante
  • Anna Rita Cervino
  • Michele Gregianin
  • Cristina Ghiotto
  • Giorgio Saladini
  • Guido Sotti
Original Article

DOI: 10.1007/s00259-010-1626-7

Cite this article as:
Evangelista, L., Baretta, Z., Vinante, L. et al. Eur J Nucl Med Mol Imaging (2011) 38: 293. doi:10.1007/s00259-010-1626-7

Abstract

Purpose

The aim of the study was to assess the role of CA 15.3, CT and positron emission tomography (PET)/CT in patients with breast cancer and suspected disease relapse after primary treatment.

Methods

We studied 111 consecutive patients (mean age 61 ± 12 years) with previous breast cancer, already treated and with clinical or biochemical suspicion of disease relapse. All patients underwent CT and 18F-fluorodeoxyglucose (FDG) PET/CT. In all patients, the value of CA 15.3 was compared to PET/CT and CT. The final diagnosis of relapse was established by invasive and noninvasive follow-up and was compared with CA 15.3, CT and PET/CT results. Univariate and multivariate analyses were used to identify the independent predictors of disease relapse and receiver-operating characteristic (ROC) curve for the identification of optimal CA 15.3 cutoff.

Results

Of all patients, 40 (36%) showed an increased CA 15.3 value, CT was positive in 73 (66%), whereas at PET/CT imaging 64 (58%) showed positive findings for disease relapse. Of 40 patients with increased marker levels, 22 patients had positive CT and 30 positive PET/CT (55 vs 75%, p < 0.001). At the end of follow-up, recurrence occurred in 32 (29%) patients, 16 (50%) of whom showed high levels of CA 15.3. PET/CT predicted relapse in 26 (81%) patients, whereas CT correctly identified 23 (72%). At univariate analysis, recurrence was significantly associated with high CA 15.3 values (p < 0.05) and positive PET/CT (p < 0.005). At multivariable analysis only positive PET/CT remained an independent predictor of disease relapse (p < 0.05). ROC analysis showed an optimal cutoff point for CA 15.3 of 19.1 U/ml (AUC 0.65, p < 0.01) to individuate positive PET/CT.

Conclusion

FDG PET/CT is more sensitive than CT and CA 15.3 in the evaluation of disease relapse. PET/CT might be considered a complementary imaging technique during follow-up in patients with breast cancer.

Keywords

Breast cancerTumour markersPositron emission tomographyDisease relapseFollow-up

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Laura Evangelista
    • 1
    • 2
  • Zora Baretta
    • 3
  • Lorenzo Vinante
    • 1
  • Anna Rita Cervino
    • 1
  • Michele Gregianin
    • 1
  • Cristina Ghiotto
    • 3
  • Giorgio Saladini
    • 1
  • Guido Sotti
    • 1
  1. 1.Radiotherapy and Nuclear Medicine UnitIstituto Oncologico Veneto IOV - IRCCSPadovaItaly
  2. 2.Departments of Biomorphological and Functional ImagingUniversity of Naples “Federico II”NaplesItaly
  3. 3.Oncology UnitIstituto Oncologico Veneto IOV - IRCCSPadovaItaly