Abstract
Objectives: In grade III-IV breast cancer, dissemination of disease needs to be assessed. Until now this was done by conventional imaging (liver ultrasonography, chest X-ray and bone scintigraphy), but evidence favoring the use of FDG-PET/CT is accumulating. Methods: Patients with high-risk breast cancer, who had received conventional imaging and FDG-PET/CT, were included. Patients were staged and assigned a treatment after 1) conventional imaging and 2) FDG-PET/CT, both by a multidisciplinary oncology team. Equivocal FDG-PET/CT findings were histologically confirmed. Results: 16 patients were included (mean age 59 years). TNM-stage changed in 5 patients (31%) after FDG-PET/CT. In 3 patients (19%) unknown distant metastases were detected by FDG-PET/CT. An adjustment of treatment took place in 4 patients (25%). Conclusions: Our case series emphasizes the role of FDG-PET/CT in the staging of high-risk breast carcinoma, especially in the assessment of distant metastases. We suggest replacing conventional imaging with FDG-PET/CT.
Highlights
364.000 patients are diagnosed with breast cancer in the European Union [1]
Conventional imaging with liver ultrasonography, chest X-ray and bone scintigraphy has been used for this purpose [2]
From August 2007 till August 2013, all patients with high risk breast cancer were retrospectively included in the present study when conventional imaging as well as FDG-PET/CT was consecutively performed within 3 months
Summary
364.000 (or 109 per 100.000) patients are diagnosed with breast cancer in the European Union [1]. Either discovered by mammography screening or through self-examination, in case of a suspicious lesion patients are referred to a radiologist to undergo an ultrasonography with histological confirmation. When this reveals breast cancer, patients are staged according to the TNM-classification and are stratified into a low-risk (stage I and II) and high-risk group (stage III and IV). The sensitivity and specificity of these methods are relatively low [2]-[4], while treatment choice is still based on the results of these tests. New modalities with higher sensitivity and specificity in the detection of metastases are needed
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