Interest of fluorodeoxyglucose (FDG)-positron emission tomography (PET) in the preoperative evaluation of breast cancer.

Abstract

e11506 Background: FDG-PET was applied to patients with breast cancer for the purpose of preoperative evaluation and surgical management. Methods: FDG-PET was performed preoperatively in 108 patients with breast cancer. The maximum standard uptake value (SUV-max) and the size of breast tumors were calculated. Axillary SUV-max and focal accumulation of FDG in the axillary region (with the help of tomodensitometry to locate the axillary region) were also evaluated. Results: Of the 108 patients, 108 had breast cancer on histopathology. PET showed focal accumulation in 101 patients. In these 101 patients, SUV-max and breast tumor size were ranged from 1.88 to 24.55 and 1.5 to 5 centimetres respectively. In all 101 cases, focal accumulation of FDG was superior at the histopathology measurement. Of the 108 patients, 77 had lymph node metastasis on histopathology. PET-FDG showed axillary focal accumulation in 40 cases (37 %), SUV-max ranged from 1.3 to 12. Of the 108 patients, 31 had not lymph node metastasis on histopathology; SUV-max was noted at zero in all 31 patients. So, what about modifications for the clinical management of breast cancer due to FDG-PET conclusions. On 45 patients (42%), FDG-PET results changed the management of the disease. In 13 cases (28.5%), clinical tumor size were noted T2 stage without focal accumulation of FDG in the axillary region, then, Sentinel Lymph Node Biopsy procedure was nevertheless initiated and total axillary dissection was avoided. In 11 cases (24%), patients had focal accumulation of FDG in axillary region but no suspect lymph node at physical examination. During surgery, node was histological studied and total axillary dissection was performed when node had metastases. In 13 cases (28.5%), FDG-PET showed unknown distant metastasis avoiding large surgery replaced by chemotherapy. In 8 cases (17%), the treatment changes for others raisons (lymphoma diagnosis, thymus cancer diagnosis, benign controlateral nodes). Only in 1 (2%) case, we mistake because of the negative axillary FDG-PET about a T2 tumor. Conclusions: FDG-PET seems to be important in the management of breast cancer to make the right choice for the treatment avoiding over treatment or under treatment. No significant financial relationships to disclose.