Aims and objectives
Aim & objectives :
To evaluate the utility of PET-CT in staging of operable breast cancer by detection of unsuspected lymph nodes and distant metastases.
To assess the correlation between SUV with the molecular subtypes.
Background :
Prognosis and survival rates for breast cancer vary greatly depending on the cancer type,
stage and treatment [1]. The treatment protocol varies depending on the stage of the disease.
Therefore,
it is necessary to correctly stage the patient for optimization of therapy,
which includes assessment of primary tumor,...
Methods and materials
Patient population:In this prospective study,
177 consecutive women (ages 26-82,
mean age 54) with unilateraloperable early breast cancer were included between December 2015 and December 2018.
Inclusion criteria :
Women above 18 yrs of age.
Stage I and II breast cancer diseases which include lesions =<5cm with or without mobile axillary lymph node.
Patients who are biopsy and clinically proven to be unilateral operable breast cancer disease without any suspicion of distant metastases.
Exclusion criteria:
History of breast surgery,
chemotherapy,
radiotherapy or any oncologic treatment....
Results
In our prospective study,
23 (12.99%) out of 177 unilateral early breast cancer patients were upstaged by PET CT -FIG.
1.
Out of twenty-three upstaged patients two patients (8.69%) were upstaged to stage IIIC and twenty-one (91.30%) to stage IV -FIG.2.
Two of stage IA patients were upstaged to stage IV,
one of whom was detected with skeletal metastases on PET-CT.
IHC subtype of the patient : Luminal A.
SUVmax of the breast lesion : 6.6 -FIG.
3.
Nine of stage IIA patients were upstaged...
Conclusion
Our study showed that FDG PET upstages around 13 % of patients in early breast cancer and some of these have metastases in different organs.
In one of our cases(FIG.
9) the primary breast lesion was subcentimeter but showed extensive metastatic disease.
Hence FDG PET can serve as a one-stop imaging technique for staging even in unilateral early breast cancer.
SUVmax within the tumor can be a marker for predicting the aggressiveness of the tumor. Literature says thatdegree of 18F-FDG uptake (SUVmax) of breast cancer...
Personal information
Dr.
Bagyam Raghavan,
Senior Consultant,
Department of Radiodiagnosis,Apollo Speciality Hospital.
Padma Complex,
320,
Anna Salai,
Rathna Nagar,
Alwarpet,
Chennai,
Tamil Nadu.
India- 600035.
Phone: 09444028839
e-mail :
[email protected]
References
Anshu Tiwari,
Shanmuga P Sundaram,
Padma Subramanyam; Role of preoperative 18-FDG-PET/CT in early breast cancer upstaging and modification of treatment: International Journal Of Cancer Therapy and Oncology 2016;4(4):4413.
M Bernsdorf,
A.K.
Berthelsen,
V.T.
Wielenga et al;Preoperative PET/CT in early stage breast cancer : Annals of oncology January 2012;23:2277-2282
Ashley M Groves,
Manu Shastry,
Simona Ben-Ham et al; Defining the Role of PET/CT in Staging Early Breast Cancer: The Oncologist 2012;17:613-61
David Groheux,
Alexandre Cochet,
Olivier Humbert et al; FDG PET/CT for staging and restaging Breast...