Skip to main content

Advertisement

SpringerLink
Log in

The Prognostic Value of 18F-FDG PET/CT for Early Recurrence in Operable Breast Cancer: Comparison with TNM Stage

  • Original Article
  • Published:
Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

We evaluated whether the maximum standardized uptake values (SUVmax) of primary tumor from the initial staging by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of patients with breast cancer could identify patients at risk for early recurrence within 2 years, particularly in comparison to the American Joint Committee on Cancer (AJCC) stage.

Methods

We reviewed the staging 18F-FDG PET/CT images of patients with primary breast cancer and their medical records. The SUVmax of the primary tumor was measured. The presence or absence of FDG uptake in the axillary lymph node (ALN) was also assessed. The patient’s pathologic primary tumor stage (pT), pathologic regional lymph node stage (pN), stage grouping, age, estrogen receptor (ER) and progesterone receptor (PR) status, and neoadjuvant chemotherapy history were evaluated with the FDG uptake parameters for recurrence within 2 years following the end of first-line therapy.

Results

Recurrence within 2 years was present in 9.1 % (n = 40) out of the 441 patients assessed. The FDG uptake in ALN, pT, pN, stage grouping and neoadjuvant chemotherapy history were prognostic for early recurrence, while primary tumor SUVmax, age, and ER or PR status were not significant on logistic regression. On multivariate analysis, only the stage grouping (odds ratio 2.79; 95 % CI 1.73, 4.48; p < 0.0001) and neoadjuvant chemotherapy history (odds ratio 2.70; 95 % CI 1.22, 5.98; p = 0.0141) could identify patients at increased risk for recurrence within 2 years.

Conclusions

Primary tumor FDG uptake measured by SUVmax, and visual assessment of FDG uptake in the ALN in the initial staging PET/CT of patients with breast cancer may not have additional prognostic value compared with the AJCC stage grouping for early recurrence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Liao C, Chang JT, Wang H, Ng S, Hsueh C, Lee L, et al. Pretreatment primary tumor SUVmax measured by FDG-PET and pathologic tumor depth predict for poor outcomes in patients with oral cavity squamous cell carcinoma and pathologically positive lymph nodes. Int J Radiat Oncol Biol Phys. 2009;73(3):764–71.

    Article  PubMed  Google Scholar 

  2. Casali C, Cucca M, Rossi G, Barbieri F, Iacuzio L, Bagni B, et al. The variation of prognostic significance of Maximum Standardized Uptake Value of [18F]-fluoro-2-deoxy-glucose positron emission tomography in different histological subtypes and pathological stages of surgically resected Non-Small Cell Lung Carcinoma. Lung Cancer. 2010;69(2):187–93.

    Article  PubMed  Google Scholar 

  3. Kidd EA, Siegel BA, Dehdashti F, Grigsby PW. Pelvic lymph node F-18 fluorodeoxyglucose uptake as a prognostic biomarker in newly diagnosed patients with locally advanced cervical cancer. Cancer. 2010;116(6):1469–75.

    Article  PubMed  Google Scholar 

  4. Song BI, Lee SW, Jeong SY, Chae YS, Lee WK, Ahn BC, et al. 18F-FDG uptake by metastatic axillary lymph nodes on pretreatment PET/CT as a prognostic factor for recurrence in patients with invasive ductal breast cancer. J Nucl Med. 2012;53(9):1337–44.

    Article  PubMed  CAS  Google Scholar 

  5. Oshida M, Uno K, Suzuki M, Nagashima T, Hashimoto H, Yagata H, et al. Predicting the prognoses of breast carcinoma patients with positron emission tomography using 2-deoxy-2-fluoro[18F]-D-glucose. Cancer. 1998;82(11):2227–34.

    Article  PubMed  CAS  Google Scholar 

  6. Alberini J, Lerebours F, Wartski M, Fourme E, Le Stanc E, Gontier E, et al. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging in the staging and prognosis of inflammatory breast cancer. Cancer. 2009;115(21):5038–47.

    Article  PubMed  Google Scholar 

  7. Inoue T, Yutani K, Taguchi T, Tamaki Y, Shiba E, Noguchi S. Preoperative evaluation of prognosis in breast cancer patients by [(18)F]2-Deoxy-2-fluoro-D-glucose-positron emission tomography. J Cancer Res Clin Oncol. 2004;130(5):273–8.

    Article  PubMed  Google Scholar 

  8. 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(4):250–8.

    Article  PubMed  Google Scholar 

  9. 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.

  10. Gil Rendo A, Martnez-Regueira F, Zornoza G, Garca-Velloso MJ, Beorlegui C, Rodriguez Spiteri N. Association between [18F]fluorodeoxyglucose uptake and prognostic parameters in breast cancer. Br J Surg. 2009;96(2):166–70.

    Article  PubMed  CAS  Google Scholar 

  11. Groheux D, Giacchetti S, Moretti J, Porcher R, Espi 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(3):426–35.

    Article  PubMed  Google Scholar 

  12. 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(6):588–93.

    Article  PubMed  Google Scholar 

  13. Hodgson NC, Gulenchyn KY. Is there a role for positron emission tomography in breast cancer staging? J Clin Oncol. 2008;26(5):712–20.

    Article  PubMed  Google Scholar 

  14. Shimoda W, Hayashi M, Murakami K, Oyama T, Sunagawa M. The relationship between FDG uptake in PET scans and biological behavior in breast cancer. Breast cancer. 2007;14(3):260–8.

    Article  PubMed  Google Scholar 

  15. Buck AK, Schirrmeister H, Mattfeldt T, Reske SN. Biological characterisation of breast cancer by means of PET. Eur J Nucl Med Mol Imaging. 2004;31 Suppl 1:S80–7.

    Article  PubMed  Google Scholar 

  16. Kidd EA, Siegel BA, Dehdashti F, Rader JS, Mutch DG, Powell MA, et al. Lymph node staging by positron emission tomography in cervical cancer: relationship to prognosis. J Clin Oncol. 2010;28(12):2108–13.

    Article  PubMed  Google Scholar 

  17. Nakajo M, Kajiya Y, Kaneko T, Kaneko Y, Takasaki T, Tani A, et al. FDG PET/CT and diffusion-weighted imaging for breast cancer: prognostic value of maximum standardized uptake values and apparent diffusion coefficient values of the primary lesion. Eur J Nucl Med Mol Imaging. 2010;37(11):2011–20.

    Article  PubMed  CAS  Google Scholar 

  18. Dunnwald LK, Gralow JR, Ellis GK, Livingston RB, Linden HM, Specht JM, et al. Tumor metabolism and blood flow changes by positron emission tomography: relation to survival in patients treated with neoadjuvant chemotherapy for locally advanced breast cancer. J Clin Oncol. 2008;26(27):4449–57.

    Article  PubMed  CAS  Google Scholar 

  19. Wahl RL, Siegel BA, Coleman RE, Gatsonis CG, Group PETS. Prospective multicenter study of axillary nodal staging by positron emission tomography in breast cancer: a report of the staging breast cancer with PET Study Group. J Clin Oncol. 2004;22(2):277–85.

    Article  PubMed  Google Scholar 

  20. National Comprehensive Cancer N. NCCN guideline update: breast cancer version 1.2004. J Natl Compr Cancer Netw JNCCN. 2004;2(3):183–4.

    Google Scholar 

  21. Reis-Filho JS, Pusztai L. Gene expression profiling in breast cancer: classification, prognostication, and prediction. Lancet. 2011;378(9805):1812–23.

    Article  PubMed  CAS  Google Scholar 

  22. Dedeurwaerder S, Fumagalli D, Fuks F. Unravelling the epigenomic dimension of breast cancers. Curr Opin Oncol. 2011;23(6):559–65.

    Article  PubMed  Google Scholar 

Download references

Disclosure

The authors report nothing to disclose.

Author information

Authors and Affiliations

  1. Department of Radiology, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seocho-gu Banpo-dong 505, Seoul, Republic of Korea, 137-701

    Joo Hyun O, Woo Hee Choi, Eun Ji Han, Eun-Kyoung Choi & Sung Hoon Kim

  2. Department of Surgery, The Catholic University of Korea, Seoul, Korea

    Byung Joo Chae

  3. Department of Biostatistics, The Catholic University of Korea, Seoul, Korea

    Yong-Gyu Park

Authors
  1. Joo Hyun O
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Woo Hee Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eun Ji Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eun-Kyoung Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Byung Joo Chae
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yong-Gyu Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sung Hoon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sung Hoon Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

O, J.H., Choi, W.H., Han, E.J. et al. The Prognostic Value of 18F-FDG PET/CT for Early Recurrence in Operable Breast Cancer: Comparison with TNM Stage. Nucl Med Mol Imaging 47, 263–267 (2013). https://doi.org/10.1007/s13139-013-0232-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13139-013-0232-6

Keywords

Search

Navigation