Abstract
BackgroundThis study was aimed 1) to investigate the predictive value of FDG PET/CT (fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography) for histopathologic response and 2) to explore the results of FDG PET/CT by molecular phenotypes of breast cancer patients who received neoadjuvant chemotherapy.MethodsSeventy-eight stage II or III breast cancer patients who received neoadjuvant docetaxel/doxorubicin chemotherapy were enrolled in this study. FDG PET/CTs were acquired before chemotherapy and after the first cycle of chemotherapy for evaluating early metabolic response.ResultsThe mean pre- and post-chemotherapy standard uptake value (SUV) were 7.5 and 3.9, respectively. The early metabolic response provided by FDG PET/CT after one cycle of neoadjuvant chemotherapy was correlated with the histopathologic response after completion of neoadjuvant chemotherapy (P = 0.002). Sensitivity and negative predictive value were 85.7% and 95.1%, respectively. The estrogen receptor negative phenotype had a higher pre-chemotherapy SUV (8.6 vs. 6.4, P = 0.047) and percent change in SUV (48% vs. 30%, P = 0.038). In triple negative breast cancer (TNBC), the pre-chemotherapy SUV was higher than in non-TNBC (9.8 vs. 6.4, P = 0.008).ConclusionsThe early metabolic response using FDG PET/CT could have a predictive value for the assessment of histopathologic non-response of stage II/III breast cancer treated with neoadjuvant chemotherapy. Our findings suggest that the initial SUV and the decline in SUV differed based on the molecular phenotype.Trial RegistrationClinicalTrials.gov: NCT01396655
Highlights
This study was aimed 1) to investigate the predictive value of FDG fluorine-18 fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) for histopathologic response and 2) to explore the results of FDG PET/CT by molecular phenotypes of breast cancer patients who received neoadjuvant chemotherapy
A few studies have been conducted in stage II or III breast cancer patients receiving neoadjuvant chemotherapy, and the role of FDG PET remains inconclusive because of the small number of patients and heterogeneous regimens [9,10,11,12,13]
In the present study, we found that the early metabolic response using serial FDG PET/CT had a high predictive value for the histopathologic non-response of stage II/III breast cancer treated with neoadjuvant chemotherapy
Summary
This study was aimed 1) to investigate the predictive value of FDG PET/CT (fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography) for histopathologic response and 2) to explore the results of FDG PET/CT by molecular phenotypes of breast cancer patients who received neoadjuvant chemotherapy. A few studies have been conducted in stage II or III breast cancer patients receiving neoadjuvant chemotherapy, and the role of FDG PET remains inconclusive because of the small number of patients and heterogeneous regimens [9,10,11,12,13]. We conducted a prospective phase II study of neoadjuvant docetaxel/ doxorubicin chemotherapy in stage II or III breast cancer and recently reported the prognostic and predictive role of the molecular markers [14,15]
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