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Erschienen in:
01.08.2015 | Breast
18 F-FDG PET/CT for initial staging in breast cancer patients – Is there a relevant impact on treatment planning compared to conventional staging modalities?
Erschienen in: European Radiology | Ausgabe 8/2015
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Objective
To evaluate the impact of whole-body 18 F-FDG PET/CT on initial staging of breast cancer in comparison to conventional staging modalities.
Methods
This study included 102 breast cancer patients, 101 patients were eligible for evaluation. Preoperative whole-body staging with PET/CT was performed in patients with clinical stage ≥ T2 tumours or positive local lymph nodes (n = 91). Postoperative PET/CT was performed in patients without these criteria but positive sentinel lymph node biopsy (n = 10). All patients underwent PET/CT and a conventional staging algorithm, which included bone scan, chest X-ray and abdominal ultrasound. PET/CT findings were compared to conventional staging and the impact on therapeutic management was evaluated.
Results
PET/CT led to an upgrade of the N or M stage in overall 19 patients (19 %) and newly identified manifestation of breast cancer in two patients (2 %). PET/CT findings caused a change in treatment of 11 patients (11 %). This is within the range of recent studies, all applying conventional inclusion criteria based on the initial T and N status.
Conclusions
PET/CT has a relevant impact on initial staging and treatment of breast cancer when compared to conventional modalities. Further studies should assess inclusion criteria beyond the conventional T and N status, e.g. tumour grading and receptor status.
Key Points
• PET/CT may be relevant in staging breast cancer patients at higher risk for metastases
• PET/CT may modify the N and M stage in multiple patients
• PET/CT may impact treatment planning in breast cancer patients