放射学组学杂志

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Value of 18F-FDG-PET/CT Initial Staging in No Metastasic Breast Cancer with Poor Prognostic Factors

Alberto Martinez Lorca, Alejandro Gallego, Cristina Escabias and Pilar Zamora

Purpose: This study analysed retrospectevely the impact of 18F-FDG-PET/CT initial staging, in women with poor prognosis factors breast cancer, in our usual practice.

Methods: From January 2009 to December 2012, initial breast cancer underwent PET/CT in 298 women with one of these poor prognosis factors: Her-2+ or triple negative phenotype, Ki 67 ≥ 14%, tumoral size and/or positive axilary lymph nodes. Only 254 patients diagnosed with mammography, ultrasonography, MRI, and bone scintigraphy accomplished inclusion criteria.

Results: 18F-FDG-PET/CT changed 13.4% to IV clinical stage, detected metastatic disease in 3.3% of patients with stage I, 13% with stage II and 17.4% with stage III. Statistical significance was found between the PET/CT metastatic disease findings and patients with stage IIB and III(A-C)(OR:3.04;IC95%:1.2-7.2;p=0.009). PET/CT also revealed N3 disease in 7.9%. According to the location, visceral affectation was found in 4.7% of the patients, metastatic lymph nodes in 3.2% and secondary bone disease in 8.7%. Her-2 negative and hormonal positive receptors group submitted a higher incidence of distant metastases, 15.5%. The more visceral and lymph node disease (N3 and distant-M1) was found in the triple negative group. Metastatic disease was observed in 28.6% of the patients above 70 years, a higher incidence than those patients with lower age (OR: 3.7; IC95%: 1.7 - 8; p = 0.01).

Conclusion: 18F-FDG-PET/CT showed to be useful in the metastatic disease detection from IIB stage patients in initial poor prognosis breast cancer patients. The incidence of distance affectation was higher in patients above 70 years and in the Her-2 negative and hormonal positive receptor group.