Original Article

Breast Cancer

, Volume 20, Issue 2, pp 167-173

First online:

Predictive value of FDG PET/CT for pathologic axillary node involvement after neoadjuvant chemotherapy

  • Bhumsuk KeamAffiliated withDepartment of Internal Medicine, Seoul National University College of MedicineCancer Research Institute, Seoul National University College of Medicine
  • , Seock-Ah ImAffiliated withDepartment of Internal Medicine, Seoul National University College of MedicineCancer Research Institute, Seoul National University College of Medicine Email author 
  • , Youngil KohAffiliated withDepartment of Internal Medicine, Seoul National University College of Medicine
  • , Sae-Won HanAffiliated withDepartment of Internal Medicine, Seoul National University College of MedicineCancer Research Institute, Seoul National University College of Medicine
  • , Do-Youn OhAffiliated withDepartment of Internal Medicine, Seoul National University College of MedicineCancer Research Institute, Seoul National University College of Medicine
  • , Nariya ChoAffiliated withDepartment of Radiology, Seoul National University College of Medicine
  • , Jee Hyun KimAffiliated withDepartment of Internal Medicine, Seoul National University College of MedicineCancer Research Institute, Seoul National University College of Medicine
  • , Wonshik HanAffiliated withDepartment of Surgery, Seoul National University College of Medicine
  • , Keon Wook KangAffiliated withCancer Research Institute, Seoul National University College of MedicineDepartment of Nuclear Medicine, Seoul National University College of Medicine
    • , Woo Kyung MoonAffiliated withDepartment of Radiology, Seoul National University College of Medicine
    • , Tae-You KimAffiliated withDepartment of Internal Medicine, Seoul National University College of MedicineCancer Research Institute, Seoul National University College of Medicine
    • , In Ae ParkAffiliated withDepartment of Pathology, Seoul National University College of Medicine
    • , Dong-Young NohAffiliated withDepartment of Surgery, Seoul National University College of Medicine
    • , June-Key ChungAffiliated withCancer Research Institute, Seoul National University College of MedicineDepartment of Nuclear Medicine, Seoul National University College of Medicine
    • , Yung-Jue BangAffiliated withDepartment of Internal Medicine, Seoul National University College of MedicineCancer Research Institute, Seoul National University College of Medicine

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Background

The purpose of this study was to determine the usefulness of sequential FDG PET/CTs for prediction of axillary lymph node (ALN) status after neoadjuvant chemotherapy (NAC).

Methods

Seventy-seven stage II or III breast cancer patients who received 3 cycles of neoadjuvant docetaxel/doxorubicin chemotherapy were enrolled in this prospective study. FDG PET/CTs were acquired before chemotherapy and after the first cycle of chemotherapy for early metabolic response prediction.

Results

Patients with pN0 had significantly lower post-NAC ALN standard uptake value (SUV) than those who were pN+ (1.22 ± 1.46 in pN0 vs. 2.13 ± 1.99 in pN+, P = 0.017). Post-NAC ALN size on CT also differed according to pathologic ALN status (6.3 mm in pN0 vs. 11.1 mm in pN+, P = 0.014). When serial FDG PET/CT and chest CT were used, patients with an SUV > 1.5 and post-NAC ALN size ≥10 mm on CT did not achieve pN0 (specificity 100% and positive predictive value 100%).

Conclusions

The serial FDG PET/CT after NAC could predict the pathologic status of ALN before surgery in stage II/III breast cancer. Our findings suggest that the combined use of serial FDG PET/CTs and chest CT might provide better information regarding ALN before surgery.

Keywords

18F-FDG PET Breast cancer Neoadjuvant chemotherapy Axillary node