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Association between 18F-FDG uptake and molecular subtype of breast cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To determine whether 18F-FDG uptake in breast cancer correlates with immunohistochemically defined subtype and is able to predict molecular subtypes.

Methods

This retrospective study involved 306 patients with 308 mass-type invasive breast cancers (mean size 2.65 cm, range 1.0–15.0 cm) who underwent 18F-FDG PET/CT before therapy. The correlations between primary tumour 18F-FDG uptake on PET/CT, expressed as SUVmax, and clinicopathological findings and molecular subtype, i.e. luminal A, luminal B (HER2-negative), luminal B (HER2-positive), HER2-positive and triple-negative, were analysed. The predictors of these subtypes were investigated.

Results

The mean SUVmax of the 308 tumours was 5.33 ± 3.63 (range 1.15–19.01). Among the subtypes of the 308 tumours, 87 (28.2 %) were luminal A, 111 (36.0 %) were luminal B (HER2-negative), 31 (10.1 %) were luminal B (HER2-positive), 26 (8.4 %) were HER2-positive and 53 (17.2 %) were triple-negative, and the corresponding mean SUVmax were 3.41 ± 2.07 (range 1.18–14.30), 5.17 ± 3.52 (range 1.35–19.01), 6.57 ± 3.84 (range 1.42–15.58), 7.55 ± 3.63 (range 2.30–13.60) and 6.97 ± 4.17 (range 1.15–16.06), respectively. A cut-off value of 3.60 yielded 70.1 % sensitivity and 66.1 % specificity with an area under the receiver operating characteristics curve (AUC) of 0.734 for predicting that a tumour was of the luminal A subtype. A cut-off value of 6.75 yielded 65.4 % sensitivity and 75.2 % specificity with an AUC of 0.704 for predicting a HER2-positive subtype.

Conclusion

SUVmax, a metabolic semiquantitative parameter, shows a significant correlation with the molecular subtype of breast cancer, and is useful for predicting the luminal A or HER2-positive subtype.

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References

  1. Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, et al. Molecular portraits of human breast tumours. Nature. 2000;406:747–52.

    Article  CAS  PubMed  Google Scholar 

  2. van ’t Veer LJ, Dai H, van de Vijver MJ, He YD, Hart AA, Mao M, et al. Gene expression profiling predicts clinical outcome of breast cancer. Nature. 2002;415:530–6.

    Article  PubMed  Google Scholar 

  3. van’t Veer LJ, Paik S, Hayes DF. Gene expression profiling of breast cancer: a new tumor marker. J Clin Oncol. 2005;23:1631–5.

    Article  Google Scholar 

  4. Paik S, Shak S, Tang G, Kim C, Baker J, Cronin M, et al. A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med. 2004;351:2817–26.

    Article  CAS  PubMed  Google Scholar 

  5. Sorlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci U S A. 2001;98:10869–74.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Cheang MC, Chia SK, Voduc D, Gao D, Leung S, Snider J, et al. Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl Cancer Inst. 2009;101:736–50.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Hugh J, Hanson J, Cheang MC, Nielsen TO, Perou CM, Dumontet C, et al. Breast cancer subtypes and response to docetaxel in node-positive breast cancer: use of an immunohistochemical definition in the BCIRG 001 trial. J Clin Oncol. 2009;27:1168–76.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thurlimann B, Senn HJ. Strategies for subtypes–dealing with the diversity of breast cancer: highlights of the St. Gallen international expert consensus on the primary therapy of early breast cancer 2011. Ann Oncol. 2011;22:1736–47.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Dubsky P, Filipits M, Jakesz R, Rudas M, Singer CF, Greil R, et al. EndoPredict improves the prognostic classification derived from common clinical guidelines in ER-positive, HER2-negative early breast cancer. Ann Oncol. 2013;24:640–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Niemiec J, Adamczyk A, Malecki K, Ambicka A, Rys J. Tumor grade and matrix metalloproteinase 2 expression in stromal fibroblasts help to stratify the high-risk group of patients with early breast cancer identified on the basis of St Gallen recommendations. Clin Breast Cancer. 2013;13:119–28.

    Article  CAS  PubMed  Google Scholar 

  11. Ueda S, Tsuda H, Asakawa H, Shigekawa T, Fukatsu K, Kondo N, et al. Clinicopathological and prognostic relevance of uptake level using 18F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in primary breast cancer. Jpn J Clin Oncol. 2008;38:250–8.

    Article  PubMed  Google Scholar 

  12. Osborne JR, Port E, Gonen M, Doane A, Yeung H, Gerald W, et al. 18F-FDG PET of locally invasive breast cancer and association of estrogen receptor status with standardized uptake value: microarray and immunohistochemical analysis. J Nucl Med. 2010;51:543–50.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Heudel P, Cimarelli S, Montella A, Bouteille C, Mognetti T. Value of PET-FDG in primary breast cancer based on histopathological and immunohistochemical prognostic factors. Int J Clin Oncol. 2010;15:588–93.

    Article  PubMed  Google Scholar 

  14. Groheux D, Giacchetti S, Moretti JL, Porcher R, Espié M, Lehmann-Che J, et al. Correlation of high 18F-FDG uptake to clinical, pathological and biological prognostic factors in breast cancer. Eur J Nucl Med Mol Imaging. 2011;38:426–35.

    Article  PubMed  Google Scholar 

  15. Wang CL, MacDonald LR, Rogers JV, Aravkin A, Haseley DR, Beatty JD. Positron emission mammography: correlation of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status and 18F-FDG. AJR Am J Roentgenol. 2011;197:W247–55.

    Article  PubMed  Google Scholar 

  16. Koolen BB, Vrancken Peeters MJ, Wesseling J, Lips EH, Vogel WV, Aukema TS, et al. Association of primary tumour FDG uptake with clinical, histopathological and molecular characteristics in breast cancer patients scheduled for neoadjuvant chemotherapy. Eur J Nucl Med Mol Imaging. 2012;39:1830–8.

    Article  CAS  PubMed  Google Scholar 

  17. Koo HR, Park JS, Kang KW, Cho N, Chang JM, Bae MS, et al. 18F-FDG uptake in breast cancer correlates with immunohistochemically defined subtypes. Eur Radiol. 2014;24:610–8.

    Article  PubMed  Google Scholar 

  18. García Vicente AM, Soriano Castrejón Á, León Martín A, Chacón López-Muñiz I, Muñoz Madero V, Muñoz Sánchez Mdel M, et al. Molecular subtypes of breast cancer: metabolic correlation with 18F-FDG PET/CT. Eur J Nucl Med Mol Imaging. 2013;40:1304–11.

    Article  PubMed  Google Scholar 

  19. Miyake KK, Nakamoto Y, Kanao S, Tanaka S, Sugie T, Mikami Y, et al. Diagnostic value of 18F-FDG PET/CT and MRI in predicting the clinicopathologic subtypes of invasive breast cancer. AJR Am J Roentgenol. 2014;203:272–9.

    Article  PubMed  Google Scholar 

  20. Murase K, Yanai A, Saito M, Imamura M, Miyagawa Y, Takatsuka Y, et al. Biological characteristics of luminal subtypes in pre- and postmenopausal estrogen receptor-positive and HER2-negative breast cancers. Breast Cancer. 2014;21:52–7.

    Article  PubMed  Google Scholar 

  21. Gianni L, Dafni U, Gelber RD, Azambuja E, Muehlbauer S, Goldhirsch A, et al. Treatment with trastuzumab for 1 year after adjuvant chemotherapy in patients with HER2-positive early breast cancer: a 4-year follow-up of a randomised controlled trial. Lancet Oncol. 2011;12:236–44.

    Article  CAS  PubMed  Google Scholar 

  22. Caudle AS, Yu TK, Tucker SL, Bedrosian I, Bedrosian I, Litton JK, et al. Local-regional control according to surrogate markers of breast cancer subtypes and response to neoadjuvant chemotherapy in breast cancer patients undergoing breast conserving therapy. Breast Cancer Res. 2012;14:R83.

    Article  PubMed Central  PubMed  Google Scholar 

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Compliance with ethical standards

Conflicts of interest

None.

Human and animal rights and informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This was a retrospective study, for which formal consent is not required. This article does not describe any studies with animals performed by any of the authors. This retrospective study was approved by the institutional review board, and the need for patient informed consent was waived.

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Authors and Affiliations

  1. Department of Nuclear Medicine and PET center, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Kazuhiro Kitajima, Kazuhito Fukushima, Yoko Igarashi, Takayuki Katsuura & Kaoru Maruyama

  2. Department of Breast and Endocrine Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Yasuo Miyoshi & Arisa Nishimukai

  3. Department of Surgical Pathology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Seiichi Hirota

  4. Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Shozo Hirota

Authors
  1. Kazuhiro Kitajima
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  2. Kazuhito Fukushima
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  3. Yasuo Miyoshi
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  4. Arisa Nishimukai
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  6. Yoko Igarashi
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  7. Takayuki Katsuura
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  8. Kaoru Maruyama
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  9. Shozo Hirota
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Correspondence to Kazuhiro Kitajima.

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Kitajima, K., Fukushima, K., Miyoshi, Y. et al. Association between 18F-FDG uptake and molecular subtype of breast cancer. Eur J Nucl Med Mol Imaging 42, 1371–1377 (2015). https://doi.org/10.1007/s00259-015-3070-1

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  • DOI: https://doi.org/10.1007/s00259-015-3070-1

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