Jin You Kim MD, Presenter: Nothing to Disclose

Suck Hong Lee, Abstract Co-Author: Nothing to Disclose

Suk Kim MD, Abstract Co-Author: Nothing to Disclose

Ji Won Lee MD, Abstract Co-Author: Nothing to Disclose

To evaluate the relevance of breast cancer subtype for the value of tumor FDG uptake for predicting axillary lymph node (ALN) metastasis in patients with invasive breast cancers.

A total of 671 patients (mean age 52.6 years, range, 23-88 years) with invasive breast cancer (mean size 2.5 cm, range, 1.0-11.7 cm) who underwent preoperative 18F-FDG PET/CT and curative surgery were identified between January 2011 and December 2013. By using immunohistochemistry, tumors were divided into three subtypes: estrogen receptor (ER) positive/human epidermal growth factor receptor 2 (HER2) negative, HER2-positive, and triple-negative. Tumor FDG uptake, expressed as maximum standardized uptake value (SUVmax) and clinicopathological variables were analyzed. Multivariate regression analysis and receiver operating characteristic analysis were performed to identify the significant factors that were associated with ALN metastasis.

ALN metastasis was present in 187 (40.6%) tumors of 461 ER-positive/HER2-negative tumors, 54 (55.7%) of 97 HER2-positive tumors, and 38 (33.6%) of 113 triple-negative tumors. Tumor SUVmax, mean tumor size, histologic grade, and Ki-67 status were significantly associated with ALN metastasis. At multivariate analysis, tumor SUVmax (adjusted odds ratio [OR] =1.046, P = 0.022) and tumor size (adjusted OR =1.608, P < 0.001) were independent significant variables associated with ALN metastasis after adjusting for potential confounding variables. The area under the receiver operating characteristic curve was 0.71 (P < 0.001). In subset analyses, the association was significant for the ER-positive/HER2-negative (P < 0.001) and HER2-positive tumors (P = 0.001). No association was found for the triple-negative tumors (P = 0.36).

Tumor SUVmax on preoperative 18F-FDG PET/CT may be an independent prognostic factor for ALN metastasis in patients with invasive breast cancer, especially in ER-positive/HER2-negative and HER2-positive subtype, but not in triple-negative subtype.

Tumor FDG uptake for predicting axillary lymph node metastasis is effective in ER-positive/HER2-negative or HER2-positive tumor but is inaccurate in triple-negative breast cancer.

Kim, J, Lee, S, Kim, S, Lee, J, 18F-FDG Uptake on Preoperative PET/CT may Predict Axillary Lymph Node Metastasis in ER-positive/HER2-negative and HER2-positive, but Not in Triple-negative Breast Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14012960.html