Breast Cancer

, Volume 20, Issue 2, pp 167–173

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

  • Bhumsuk Keam
  • Seock-Ah Im
  • Youngil Koh
  • Sae-Won Han
  • Do-Youn Oh
  • Nariya Cho
  • Jee Hyun Kim
  • Wonshik Han
  • Keon Wook Kang
  • Woo Kyung Moon
  • Tae-You Kim
  • In Ae Park
  • Dong-Young Noh
  • June-Key Chung
  • Yung-Jue Bang
Original Article

DOI: 10.1007/s12282-011-0323-0

Cite this article as:
Keam, B., Im, S., Koh, Y. et al. Breast Cancer (2013) 20: 167. doi:10.1007/s12282-011-0323-0

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 PETBreast cancerNeoadjuvant chemotherapyAxillary node

Copyright information

© The Japanese Breast Cancer Society 2012

Authors and Affiliations

  • Bhumsuk Keam
    • 1
    • 2
  • Seock-Ah Im
    • 1
    • 2
  • Youngil Koh
    • 1
  • Sae-Won Han
    • 1
    • 2
  • Do-Youn Oh
    • 1
    • 2
  • Nariya Cho
    • 3
  • Jee Hyun Kim
    • 1
    • 2
  • Wonshik Han
    • 4
  • Keon Wook Kang
    • 2
    • 5
  • Woo Kyung Moon
    • 3
  • Tae-You Kim
    • 1
    • 2
  • In Ae Park
    • 6
  • Dong-Young Noh
    • 4
  • June-Key Chung
    • 2
    • 5
  • Yung-Jue Bang
    • 1
    • 2
  1. 1.Department of Internal MedicineSeoul National University College of MedicineSeoulKorea
  2. 2.Cancer Research InstituteSeoul National University College of MedicineSeoulKorea
  3. 3.Department of RadiologySeoul National University College of MedicineSeoulKorea
  4. 4.Department of SurgerySeoul National University College of MedicineSeoulKorea
  5. 5.Department of Nuclear MedicineSeoul National University College of MedicineSeoulKorea
  6. 6.Department of PathologySeoul National University College of MedicineSeoulKorea