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Current Status and Future Prospects in Breast Carcinoma of Positron Emission Tomography

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Breast Cancer Risk Reduction and Early Detection

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Abstract

In this communication, we explore the current status and future prospects of positron emission tomography (PET) imaging in breast carcinoma. While the use of FDG-PET in the evaluation and management of cancer patients continues to increase, its precise role in the management of breast carcinoma is not yet clearly defined. Currently the most useful applications are in monitoring response to therapy (especially neoadjuvant chemotherapy for locally advanced breast cancer), diagnosis of recurrent and metastatic disease, and defining tumor biology based upon FDG uptake in the lesion. PET has a limited role in diagnosing the primary malignancy, especially in patients with small tumors and those with lobular carcinoma, but can prove useful in certain specific and difficult situations (e.g., in patients with dense breast tissue, significant fibrocystic changes, fibrosis after radiotherapy, and inconclusive results from MR imaging and other imaging modalities). FDG-PET has a relatively low sensitivity for detection of diseased axillary nodes, but the predictive value of a positive PET is very high. We have found that quantitative FDG-PET parameters help define and predict tumor biology. FDG uptake in the index lesion correlates well with tumor aggressiveness, and partial volume correction of the standardized uptake value substantially improves its accuracy especially in lesions less than 2.5 cm in diameter. In this review, we discuss the clinical utility of PET vis-à-vis existing modalities.

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Acknowledgments

This work was supported by U.S. Public Health Services Research grant M01-RR00040 from the National Institutes of Health. It was also supported in part by the International Union against Cancer (UICC), Geneva, Switzerland, under the American Cancer Society International Fellowship for the Beginning Investigators (ACSBI fellowship).

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Authors and Affiliations

  1. Radiation Medicine Centre (Bhabha Atomic Research Centre), Tata Memorial Hospital Annexe, Parel, Bombay, 400012, India

    Sandip Basu

  2. Division of Nuclear Medicine, Department of Radiology, Hospital of University of Pennsylvania, Philadelphia, PA, 19104, USA

    Joshua I. Rosenbaum BA

  3. Department of Radiology, Hospital of University of Pennsylvania, Philadelphia, PA, 19104, USA

    Abass Alavi MD PhD (Hon) DSc (Hon)

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  1. Sandip Basu
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  2. Joshua I. Rosenbaum BA
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  3. Abass Alavi MD PhD (Hon) DSc (Hon)
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Correspondence to Sandip Basu .

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Editors and Affiliations

  1. School of Medicine & Health Sciences, University of North Dakota, N. Columbia Road 501, Grand Forks, 58203, U.S.A.

    Edward R. Sauter

  2. Dept. Medical Oncology, Fox Chase Cancer Center, Cottman Ave. 333, Philadelphia, 19111-2497, U.S.A.

    Mary B. Daly

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Basu, S., Rosenbaum, J.I., Alavi, A. (2010). Current Status and Future Prospects in Breast Carcinoma of Positron Emission Tomography. In: Sauter, E., Daly, M. (eds) Breast Cancer Risk Reduction and Early Detection. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-87583-5_7

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  • DOI: https://doi.org/10.1007/978-0-387-87583-5_7

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