Abstract
Invasive lobular breast cancer represents the second most prevalent histological type of breast cancer after invasive ductal cancer (IDC) and its incidence has been constantly growing in the last few years. This trend is largely related to the use of MR as a radiological diagnostic method of second level. We have analyzed our institutional case and the use FDG CT/PET in this case. FDG CT/PET demonstrates lower SUV and less accuracy both in primary as well as in metastastic ILC compared to IDC. Moreover, the patterns of metastatic spread differ between ILC and IDC. We think that for this type of cancer could be use CT-PET with a particular metabolite: 1 [18F]-Fluoroestradiol (18F-FES-PET). 18F-FES-PET has the potential to assess heterogeneity in ER expression that are expressed in lobular breast cancer.
Highlights
We have read with high interest the results published by Linden et al [1]
Invasive lobular breast cancer (ILBC) represents the second most prevalent histological type of breast cancer after invasive ductal cancer and its incidence has been constantly growing in the last few years [2]
In the last 5 years we had evaluated 27 case of ILBC with abdominal metastasize, 17 patients were submitted to CT-biopsy for define the origin of the abdominal-mass, 2 patients were submitted by surgery for abdominal obstruction for masslike effect
Summary
We have read with high interest the results published by Linden et al [1]. FES PET/CT could help predict endocrine therapy response and can identify tumor heterogeneity and may facilitate selection of the optimal biopsy site or confirm metastatic diagnosis if biopsy is not possible. Invasive lobular breast cancer (ILBC) represents the second most prevalent histological type of breast cancer after invasive ductal cancer and its incidence has been constantly growing in the last few years [2]. In the last 5 years we had evaluated 27 case of ILBC with abdominal metastasize, 17 patients were submitted to CT-biopsy for define the origin of the abdominal-mass, 2 patients were submitted by surgery for abdominal obstruction for masslike effect. In the cases where the surgical intervention has been performed with histological sampling, has been confirmed the diagnosis abdominal metastasis of lobular breast cancer with positive. In the 50% of the cases 18FDG CT/PET has been performed but there wasn’t any uptake in abdominal district. FDG CT/PET demonstrates lower SUV and less accuracy both in primary as well as in metastastic ILC compared to IDC [5]. The patterns of metastatic spread differ between ILC and IDC [6]
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