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Degree of Tumor FDG Uptake Correlates with Proliferation Index in Triple Negative Breast Cancer

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Abstract

Purpose

2-Deoxy-2-[F-18]fluoro-D-glucose (FDG) uptake may be a useful surrogate marker for proliferation index, but the correlation has not always been clear-cut. Previous research by our group suggests that FDG-positron emission tomography (PET) is sensitive in detecting triple negative breast cancer. We therefore performed a pilot study to test if FDG uptake correlated with proliferation index in women with triple negative cancer.

Procedures

To determine whether proliferation index correlates with metabolic uptake of FDG in women with triple negative breast cancer, we performed a retrospective analysis correlating %Ki67 nuclear stain with tumor maximum standardized uptake values (SUVmax) in a group of 41 women, 22 with triple negative and 19 with non-triple negative breast cancer.

Results

As expected, [18F]-PET imaging was significantly more sensitive in detecting triple negative breast cancer than non-triple negative breast cancer, 95.5% vs 68.4% (p = 0.036). In general, SUVmax and %Ki67 nuclear stain values rise as histologic grade worsens. Histologic grade of triple negative breast cancer was more often poorly differentiated than non-triple negative cancer (p = 0.001). SUVmax correlated with %Ki67 nuclear staining in our entire cohort (spearman correlation = 0.485, p = 0.002). Moreover, this significant correlation appeared to be driven primarily by a subset of women with triple negative cancer (spearman correlation = 0.497, p = 0.019).

Conclusions

Degree of tumor FDG uptake correlated significantly with proliferation index in women with triple negative breast cancer suggesting a potential role of FDG-PET in treatment response monitoring for this group of women. Future studies are necessary to define the role of PET imaging as a non-invasive means to monitor breast cancer treatment response in the neoadjuvant setting.

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Acknowledgement

We thank Dr. Paul Zhang for interpreting immunohistochemistry analyses of ER, PR, and Her2/neu.

Competing interests

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Abramson Cancer Center, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA

    Julia Tchou, Seema S. Sonnad & Mitchell Schnall

  2. Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA

    Julia Tchou & Meredith R. Bergey

  3. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA

    Seema S. Sonnad

  4. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA

    Seema S. Sonnad

  5. Division of Nuclear Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Sandip Basu & Abass Alavi

  6. Radiation Medicine Center, Tata Memorial Hospital Annex, Parel, Mumbai, India

    Sandip Basu

  7. Department of Anatomic Pathology, University of Pennsylvania, Philadelphia, PA, USA

    John Tomaszewski

  8. Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA

    Mitchell Schnall

Authors
  1. Julia Tchou
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  2. Seema S. Sonnad
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  3. Meredith R. Bergey
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  4. Sandip Basu
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  5. John Tomaszewski
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  6. Abass Alavi
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  7. Mitchell Schnall
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Corresponding authors

Correspondence to Julia Tchou or Mitchell Schnall.

Additional information

Grant Support

This study is supported, in part, by the American College of Surgeons Faculty Research Fellowship, Commonwealth Tobacco Funds (Health Research Formula Fund), and Grant #IRG-78-002-26 from the American Cancer Society (JT), and by a grant P01CA85424 (MS). This study was presented in part at the 30th Annual San Antonio Breast Cancer Symposium, December 13–16, 2007.

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Tchou, J., Sonnad, S.S., Bergey, M.R. et al. Degree of Tumor FDG Uptake Correlates with Proliferation Index in Triple Negative Breast Cancer. Mol Imaging Biol 12, 657–662 (2010). https://doi.org/10.1007/s11307-009-0294-0

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  • DOI: https://doi.org/10.1007/s11307-009-0294-0

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