Skip to main content
Erschienen in: Annals of Nuclear Medicine 4/2012

01.05.2012 | Original article

Increased FDG uptake in breast cancer is associated with prognostic factors

verfasst von: Yasemin Sanli, Serkan Kuyumcu, Zeynep Gozde Ozkan, Göknur Işık, Hasan Karanlik, Burcu Guzelbey, Cuneyt Turkmen, Sevda Ozel, Ekrem Yavuz, Ayse Mudun

Erschienen in: Annals of Nuclear Medicine | Ausgabe 4/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the relationship between FDG uptake and prognostic factors of breast cancer such as hormone receptors (estrogen and progesterone), expression of c-erbB-2, axillary lymph node status, tumor histology, grade and size.

Materials and methods

Between May 2009 and February 2011; 79 patients (mean age ± SD: 52.9 ± 13.9 years) with biopsy proven breast cancer underwent F-18 FDG PET/CT scanning for staging. Patients with excisional biopsy or neoadjuvant chemotherapy were excluded from the study. Histological types included were invasive ductal carcinoma (n = 68), invasive lobular carcinoma (n = 2), and invasive ductal plus lobular mixed carcinoma (n = 9). Maximum standardized uptake values (SUVmax) were compared with estrogen (ER) and progesterone receptors (PR), expression of c-erbB-2, as well as tumor grade and tumor size. For the evaluation of relationship between tumor SUVmax values and prognosticators such as hormone receptors, tumor histologic grade, and tumor size, statistical analyses were performed using Student t test, Mann–Whitney U Test and Pearson correlation coefficient and p values of less than 0.05 were considered to indicate statistically significant differences.

Results

All primary breast neoplasms were detected by PET/CT scanner. The mean SUVmax values and breast cancer tumor sizes ranged from 2.09 to 39.0 and 0.7 to 10 cm, respectively. Tumors with negative ER [(n = 19); SUVmax median (min–max): 15 (2.09–39.0)] were associated with higher SUVmax values (p = 0.01). Tumors with overexpression of C-erbB-2 [(n = 28); SUVmax median (min–max): 16.0 (5.0-39.0)]; tumor grade 3 [(n = 25); SUVmax median (min–max): 15 (6.43–39)]; axillary lymph node involvement [(n = 60); SUVmax median (min–max): 13.61 (4.0–39.0)]; tumor histopathology and increased tumor size were associated with higher maximum standardized uptake values. However, PR did not show any relationship with SUVmax values.

Conclusion

In the present report, strong relationships were detected between the negativity of ER, overexpression of c-erbB-2, tumor grade, tumor size, histopathology, axillary lymph node involvement and SUVmax values. Accordingly, we believe that SUVmax values obtained with 18F-FDG PET/CT may provide some information about tumor biology of breast cancer.
Literatur
1.
Zurück zum Zitat Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, et al. Cancer statistics, 2005. CA Cancer J Clin. 2005;55:10–30.PubMedCrossRef Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, et al. Cancer statistics, 2005. CA Cancer J Clin. 2005;55:10–30.PubMedCrossRef
2.
Zurück zum Zitat Osborne JR, Port E, Gonen M, Doane A, Yeung H, Gerald W, et al. 18F-FDG PET of locally invasive breast cancer and association of estrogen receptor status with standardized uptake value: microarray and immunohistochemical analysis. J Nucl Med. 2010;51:543–50.PubMedCrossRef Osborne JR, Port E, Gonen M, Doane A, Yeung H, Gerald W, et al. 18F-FDG PET of locally invasive breast cancer and association of estrogen receptor status with standardized uptake value: microarray and immunohistochemical analysis. J Nucl Med. 2010;51:543–50.PubMedCrossRef
3.
Zurück zum Zitat Dunnwald LK, Doot RK, Specht JM, Gralow JR, Ellis GK, Livingston RB, et al. PET tumor metabolism in locally advanced breast cancer patients undergoing neoadjuvant chemotherapy: value of static versus kinetic measures of fluorodeoxyglucose uptake. Clin Cancer Res. 2011;17:2400–9.PubMedCrossRef Dunnwald LK, Doot RK, Specht JM, Gralow JR, Ellis GK, Livingston RB, et al. PET tumor metabolism in locally advanced breast cancer patients undergoing neoadjuvant chemotherapy: value of static versus kinetic measures of fluorodeoxyglucose uptake. Clin Cancer Res. 2011;17:2400–9.PubMedCrossRef
4.
Zurück zum Zitat Oshida M, Uno K, Suzuki M, Nagashima T, Hashimoto H, Yagata H, et al. Predicting the prognoses of breast carcinoma patients with positron emission tomography using 2-deoxy-2-fluoro[18F]-d-glucose. Cancer. 1998;82:2227–34.PubMedCrossRef Oshida M, Uno K, Suzuki M, Nagashima T, Hashimoto H, Yagata H, et al. Predicting the prognoses of breast carcinoma patients with positron emission tomography using 2-deoxy-2-fluoro[18F]-d-glucose. Cancer. 1998;82:2227–34.PubMedCrossRef
5.
Zurück zum Zitat Berriolo-Riedinger A, Touzery C, Riedinger JM, Toubeau M, Coudert B, Arnould L, et al. 18F-FDG-PET predicts complete pathological response of breast cancer to neoadjuvant chemotherapy. Eur J Nucl Med Mol Imaging. 2007;34:1915–24.PubMedCrossRef Berriolo-Riedinger A, Touzery C, Riedinger JM, Toubeau M, Coudert B, Arnould L, et al. 18F-FDG-PET predicts complete pathological response of breast cancer to neoadjuvant chemotherapy. Eur J Nucl Med Mol Imaging. 2007;34:1915–24.PubMedCrossRef
6.
Zurück zum Zitat Duch J, Fuster D, Muñoz M, Fernández PL, Paredes P, Fontanillas M, et al. 18F-FDG PET/CT for early prediction of response to neoadjuvant chemotherapy in breast cancer. Eur J Nucl Med Mol Imaging. 2009;36:1551–7.PubMedCrossRef Duch J, Fuster D, Muñoz M, Fernández PL, Paredes P, Fontanillas M, et al. 18F-FDG PET/CT for early prediction of response to neoadjuvant chemotherapy in breast cancer. Eur J Nucl Med Mol Imaging. 2009;36:1551–7.PubMedCrossRef
7.
Zurück zum Zitat Borg A, Tandon AK, Sigurdsson H, Clark GM, Fernö M, Fuqua SA, et al. HER-2/neu amplification predicts poor survival in node-positive breast cancer. Cancer Res. 1990;50:4332–7.PubMed Borg A, Tandon AK, Sigurdsson H, Clark GM, Fernö M, Fuqua SA, et al. HER-2/neu amplification predicts poor survival in node-positive breast cancer. Cancer Res. 1990;50:4332–7.PubMed
8.
Zurück zum Zitat Knight WA, Livingston RB, Gregory EJ, McGuire WL. Estrogen receptor as an independent prognostic factor for early recurrence in breast cancer. Cancer Res. 1977;37:4669–71.PubMed Knight WA, Livingston RB, Gregory EJ, McGuire WL. Estrogen receptor as an independent prognostic factor for early recurrence in breast cancer. Cancer Res. 1977;37:4669–71.PubMed
9.
Zurück zum Zitat Parkes HC, Lillycrop K, Howell A, Craig RK. C-erbB2 mRNA expression in human breast tumours: comparison with c-erbB2 DNA amplification and correlation with prognosis. Br J Cancer. 1990;61:39–45.PubMedCrossRef Parkes HC, Lillycrop K, Howell A, Craig RK. C-erbB2 mRNA expression in human breast tumours: comparison with c-erbB2 DNA amplification and correlation with prognosis. Br J Cancer. 1990;61:39–45.PubMedCrossRef
10.
Zurück zum Zitat Harris L, Fritsche H, Mennel R, Norton L, Ravdin P, Taube S, et al. American Society of Clinical Oncology 2007 update of recommendations fort the use of tumor markers in breast cancer. J Clin Oncol. 2007;25:5287–312.PubMedCrossRef Harris L, Fritsche H, Mennel R, Norton L, Ravdin P, Taube S, et al. American Society of Clinical Oncology 2007 update of recommendations fort the use of tumor markers in breast cancer. J Clin Oncol. 2007;25:5287–312.PubMedCrossRef
11.
Zurück zum Zitat Avril N, Menzel M, Dose J, Schelling M, Weber W, Jänicke F, et al. Glucose metabolism of breast cancer assessed by 18F-FDG PET: histologic and immunohistochemical tissue analysis. J Nucl Med. 2001;42:9–16.PubMed Avril N, Menzel M, Dose J, Schelling M, Weber W, Jänicke F, et al. Glucose metabolism of breast cancer assessed by 18F-FDG PET: histologic and immunohistochemical tissue analysis. J Nucl Med. 2001;42:9–16.PubMed
12.
Zurück zum Zitat Bos R, van Der Hoeven JJ, van Der Wall E, Bos R, van Der Hoeven JJ, van Der Wall E, et al. Biologic correlates of (18)fluorodeoxyglucose uptake in human breast cancer measured by positron emission tomography. J Clin Oncol. 2002;20:379–87.PubMedCrossRef Bos R, van Der Hoeven JJ, van Der Wall E, Bos R, van Der Hoeven JJ, van Der Wall E, et al. Biologic correlates of (18)fluorodeoxyglucose uptake in human breast cancer measured by positron emission tomography. J Clin Oncol. 2002;20:379–87.PubMedCrossRef
13.
Zurück zum Zitat Elston CW, Ellis IO. Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology. 1991;19:403–10.PubMedCrossRef Elston CW, Ellis IO. Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology. 1991;19:403–10.PubMedCrossRef
14.
Zurück zum Zitat Mavi A, Cermik TF, Urhan M, Puskulcu H, Basu S, Yu JQ, et al. The effects of estrogen, progesterone, and C-erbB-2 receptor states on 18F-FDG uptake of primary breast cancer lesions. J Nucl Med. 2007;48:1266–72.PubMedCrossRef Mavi A, Cermik TF, Urhan M, Puskulcu H, Basu S, Yu JQ, et al. The effects of estrogen, progesterone, and C-erbB-2 receptor states on 18F-FDG uptake of primary breast cancer lesions. J Nucl Med. 2007;48:1266–72.PubMedCrossRef
15.
Zurück zum Zitat Ueda S, Tsuda H, Asakawa H, Shigekawa T, Fukatsu K, Kondo N, et al. Clinicopathological and prognostic relevance of uptake level using 18F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in primary breast cancer. Jpn J Clin Oncol. 2008;38:250–8.PubMedCrossRef Ueda S, Tsuda H, Asakawa H, Shigekawa T, Fukatsu K, Kondo N, et al. Clinicopathological and prognostic relevance of uptake level using 18F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in primary breast cancer. Jpn J Clin Oncol. 2008;38:250–8.PubMedCrossRef
16.
Zurück zum Zitat Buck A, Schirrmeister H, Kühn T, Shen C, Kalker T, Kotzerke J, et al. FDG uptake in breast cancer: correlation with biological and clinical prognostic parameters. Eur J Nucl Med Mol Imaging. 2002;29:1317–23.PubMedCrossRef Buck A, Schirrmeister H, Kühn T, Shen C, Kalker T, Kotzerke J, et al. FDG uptake in breast cancer: correlation with biological and clinical prognostic parameters. Eur J Nucl Med Mol Imaging. 2002;29:1317–23.PubMedCrossRef
17.
Zurück zum Zitat Heudel P, Cimarelli S, Montella A, Bouteille C, Mognetti T. Value of PET-FDG in primary breast cancer based on histopathological and immunohistochemical prognostic factors. Int J Clin Oncol. 2010;15:588–93.PubMedCrossRef Heudel P, Cimarelli S, Montella A, Bouteille C, Mognetti T. Value of PET-FDG in primary breast cancer based on histopathological and immunohistochemical prognostic factors. Int J Clin Oncol. 2010;15:588–93.PubMedCrossRef
18.
Zurück zum Zitat Costelloe CM, Rohren EM, Madewell JE, Hamaoka T, Theriault RL, Yu TK, et al. Imaging bone metastases in breast cancer: techniques and recommendations for diagnosis. Lancet Oncol. 2009;10:606–14.PubMedCrossRef Costelloe CM, Rohren EM, Madewell JE, Hamaoka T, Theriault RL, Yu TK, et al. Imaging bone metastases in breast cancer: techniques and recommendations for diagnosis. Lancet Oncol. 2009;10:606–14.PubMedCrossRef
19.
20.
Zurück zum Zitat Higashi T, Tamaki N, Honda T, Torizuka T, Kimura T, Inokuma T, et al. Expression of glucose transporters in human pancreatic tumors compared with increased FDG accumulation in PET study. J Nucl Med. 1997;38:1337–44.PubMed Higashi T, Tamaki N, Honda T, Torizuka T, Kimura T, Inokuma T, et al. Expression of glucose transporters in human pancreatic tumors compared with increased FDG accumulation in PET study. J Nucl Med. 1997;38:1337–44.PubMed
21.
Zurück zum Zitat Reske SN, Grillenberger KG, Glatting G, Port M, Hildebrandt M, Gansauge F, et al. Overexpression of glucose transporter 1 and increased FDG uptake in pancreatic carcinoma. J Nucl Med. 1997;38:1344–8.PubMed Reske SN, Grillenberger KG, Glatting G, Port M, Hildebrandt M, Gansauge F, et al. Overexpression of glucose transporter 1 and increased FDG uptake in pancreatic carcinoma. J Nucl Med. 1997;38:1344–8.PubMed
22.
Zurück zum Zitat Slamon DJ, Clark GM, Wong SG, Levin WJ, Ullrich A, McGuire WL. Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science. 1987;235:177–82.PubMedCrossRef Slamon DJ, Clark GM, Wong SG, Levin WJ, Ullrich A, McGuire WL. Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science. 1987;235:177–82.PubMedCrossRef
23.
Zurück zum Zitat Basu S, Chen W, Tchou J, Mavi A, Cermik T, Czerniecki B, et al. Comparison of triple-negative and estrogen receptor-positive/progesterone receptor-positive/HER2-negative breast carcinoma using quantitative fluorine-18 fluorodeoxyglucose/positron emission tomography imaging parameters: a potentially useful method for disease characterization. Cancer. 2008;112:995–1000.PubMedCrossRef Basu S, Chen W, Tchou J, Mavi A, Cermik T, Czerniecki B, et al. Comparison of triple-negative and estrogen receptor-positive/progesterone receptor-positive/HER2-negative breast carcinoma using quantitative fluorine-18 fluorodeoxyglucose/positron emission tomography imaging parameters: a potentially useful method for disease characterization. Cancer. 2008;112:995–1000.PubMedCrossRef
24.
Zurück zum Zitat Straver ME, Aukema TS, Olmos RA, Rutgers EJ, Gilhuijs KG, Schot ME, et al. Feasibility of FDG PET/CT to monitor the response of axillary lymph node metastases to neoadjuvant chemotherapy in breast cancer patients. Eur J Nucl Med. 2010;37:1069–76.CrossRef Straver ME, Aukema TS, Olmos RA, Rutgers EJ, Gilhuijs KG, Schot ME, et al. Feasibility of FDG PET/CT to monitor the response of axillary lymph node metastases to neoadjuvant chemotherapy in breast cancer patients. Eur J Nucl Med. 2010;37:1069–76.CrossRef
25.
Zurück zum Zitat Hodgson NC, Gulenchyn KY. Is there a role for positron emission tomography in breast cancer staging? J Clin Oncol. 2008;26:712–20.PubMedCrossRef Hodgson NC, Gulenchyn KY. Is there a role for positron emission tomography in breast cancer staging? J Clin Oncol. 2008;26:712–20.PubMedCrossRef
26.
Zurück zum Zitat Greco M, Crippa F, Agresti R, Seregni E, Gerali A, Giovanazzi R, et al. Axillary lymph node staging in breast cancer by 2-fluoro-2-deoxy-d-glucose-positron emission tomography: clinical evaluation and alternative management. J Natl Cancer Inst. 2001;93:630–5.PubMedCrossRef Greco M, Crippa F, Agresti R, Seregni E, Gerali A, Giovanazzi R, et al. Axillary lymph node staging in breast cancer by 2-fluoro-2-deoxy-d-glucose-positron emission tomography: clinical evaluation and alternative management. J Natl Cancer Inst. 2001;93:630–5.PubMedCrossRef
Metadaten
Titel
Increased FDG uptake in breast cancer is associated with prognostic factors
verfasst von
Yasemin Sanli
Serkan Kuyumcu
Zeynep Gozde Ozkan
Göknur Işık
Hasan Karanlik
Burcu Guzelbey
Cuneyt Turkmen
Sevda Ozel
Ekrem Yavuz
Ayse Mudun
Publikationsdatum
01.05.2012
Verlag
Springer Japan
Erschienen in
Annals of Nuclear Medicine / Ausgabe 4/2012
Print ISSN: 0914-7187
Elektronische ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-012-0579-2

Weitere Artikel der Ausgabe 4/2012

Annals of Nuclear Medicine 4/2012 Zur Ausgabe