Maria G. Skilakaki MD, Presenter: Nothing to Disclose

Chariklia Giannopoulou MD, Abstract Co-Author: Nothing to Disclose

Phivi Rondogianni MD, Abstract Co-Author: Nothing to Disclose

James Exarhos MD, Abstract Co-Author: Nothing to Disclose

Irene Houssianakou MD, Abstract Co-Author: Nothing to Disclose

Ioannis Datseris MD, Abstract Co-Author: Nothing to Disclose

PURPOSE: To compare the ability of 18F FDG-PET/CT with conventional staging studies in the detection of recurrent and/or metastatic disease in patients with known breast cancer.

METHOD AND MATERIALS: This retrospective study initially involved 76 patients (75 women, 1man) with breast cancer, 30-76 years old (mean age:53.4 years), who had PET/CT at our Hospital from February 2007 to March 2008. Patients were mostly asymptomatic with elevated tumor markers and/or equivocal findings on recent conventional imaging (CT, MRI, bone scintigraphy). 13 women were subsequently excluded from our study, 10 because of a coexistent second (6 patients) or third (4 patients) malignancy and 3 due to inadequate medical records. Two physicians (one nuclear medicine physician and one radiologist) reviewed all imaging findings and accuracy of PET/CT was compared to histopathology (52 patients-82.5%-) or follow-up (11 patients-17.5%-).

RESULTS: PET/CT changed the extent of disease in 37 (58.7%) patients (increased in 20 and decreased in 17). PET/CT changed the clinical stage in 25 (39.7%) patients: identified occult disease in 8 patients (12.7%), correctly excluded disease in 13 patients (20.6%) and revealed less extensive disease in 4 patients (6.3%). PET/CT and conventional imaging modalities were concordant in 23 patients (36.5%): in 12 patients in excluding disease and in 11 patients in showing the same clinical stage and extent of disease. Furthermore, in 3 patients PET/CT revealed a second new malignancy (one ovarian cancer and two oral cavity carcinomas).  

CONCLUSION: We think that 18F FDG-PET/CT may be sufficient enough in the evaluation of recurrent and/or metastatic disease in patients with known breast cancer. Further investigation with prospective studies is needed to address this hypothesis.

The combination of FDG-PET with CT by PET/CT may provide “one-stop shopping” for breast cancer staging as CT may be able to detect small pulmonary nodules and sclerotic bone lesions missed by FDG-PET.

Skilakaki, M, Giannopoulou, C, Rondogianni, P, Exarhos, J, Houssianakou, I, Datseris, I, Breast Cancer: Diagnosis of Recurrent and/or Metastatic Disease Using 18F FDG-PET/CT.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6012753.html