Abstract
Objective:Our aim was to assess the diagnostic performance of integrated positron emission tomography/computed tomography (PET/CT) in the follow-up of breast cancer patients, who underwent a PET/CT scan due to a suspicion of recurrence based on elevated levels of serum tumor markers.Methods:Seventy-seven consecutive patients were included in this study. PET/CT scan results were compared with the final diagnoses that were obtained from histopathological sampling or a minimum 6 months of radiological follow-up. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the diagnostic accuracy of PET/CT for detecting recurrence were calculated.Results:All 77 patients had increased serum cancer antigen 15-3 levels while 37 had increased serum carcinoembryonic antigen levels. According to PET/CT scan results, 59 of 77 patients (PET/CT positive) had local recurrence and/or distant metastasis while there was no pathological finding in 18 patients (PET/CT negative). In a follow-up of minimum 6 months, tumor recurrence was confirmed in 58 of “PET/CT positive” patients while no tumor recurrence was detected in 16 of “PET/CT negative” patients. According to these results the sensitivity, specificity, PPV, NPV and the diagnostic accuracy of PET/CT for detecting recurrence on a per-person basis were calculated as 98%, 88%, 96%, 94% and 96%, respectively.Conclusion:In case of elevated levels of serum tumor markers, PET/CT has a high diagnostic accuracy in detecting tumor recurrence in patients with breast cancer, and it is an effective modality that can be used in addition to conventional imaging techniques.
Highlights
Breast cancer is the most common cancer among females
Seventy-seven consecutive patients who were followedup for breast cancer and who underwent 18F-FDG positron emission tomography (PET)/ computed tomography (CT) scan due to suspicion of recurrence based on elevated levels of serum tumor markers (CA 15-3 and carcinoembryonic antigen (CEA)) were included in this study
positron emission tomography/computed tomography (PET/CT) scan results were compared with the final diagnoses that were obtained from histopathologic sampling or at least 6 months of radiological follow-up
Summary
Breast cancer is the most common cancer among females. It is the leading cause of cancer related death among females worldwide, with an estimated 1,7 million new cases and 521.900 deaths in 2012 [1].Recurrence in breast cancer can occur even after 15 years following primary therapy, requiring life-long routine follow-up [2]. Breast cancer is the most common cancer among females. It is the leading cause of cancer related death among females worldwide, with an estimated 1,7 million new cases and 521.900 deaths in 2012 [1]. Recurrence in breast cancer can occur even after 15 years following primary therapy, requiring life-long routine follow-up [2]. Detection of tumor recurrence improves long-term survival rates as well as quality of life. Cancer antigen 15-3 (CA 15-3) and carcinoembryonic antigen (CEA) are two frequently used tumor markers in the follow-up of breast cancer [3,4]. The results of many studies about these tumor markers in follow-up of breast cancer are inconsistent, even conflicting with each other. Previous studies have been conducted to quantitatively evaluate the serum levels of these two tumor markers and some found no significant correlation between increased tumor marker levels and recurrence while some found a significant correlation between them [5,6,7]
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