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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-03-2014 | Original Article

¹⁸F-FDG PET/CT provides powerful prognostic stratification in the primary staging of large breast cancer when compared with conventional explorations

Authors: Alexandre Cochet, Inna Dygai-Cochet, Jean-Marc Riedinger, Olivier Humbert, Alina Berriolo-Riedinger, Michel Toubeau, Séverine Guiu, Charles Coutant, Bruno Coudert, Pierre Fumoleau, François Brunotte

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 3/2014

Abstract

Purpose

The objective of this study was to assess the impact on management and the prognostic value of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT for initial staging of newly diagnosed large breast cancer (BC) when compared with conventional staging.

Methods

We prospectively included 142 patients with newly diagnosed BC and at least grade T2 tumour. All patients were evaluated with complete conventional imaging (CI) procedures (mammogram and/or breast ultrasound, bone scan, abdominal ultrasound and/or CT, X-rays and/or CT of the chest), followed by FDG PET/CT exploration, prior to treatment. The treatment plan based on CI staging was compared with that based on PET/CT findings. CI and PET/CT findings were confirmed by imaging and clinical follow-up and/or pathology when assessable. Progression-free survival (PFS) was analysed using the Cox proportional hazards regression model.

Results

According to CI staging, 79 patients (56 %) were stage II, 46 (32 %) stage III and 17 (12 %) stage IV (distant metastases). Of the patients, 30 (21 %) were upstaged by PET/CT, including 12 (8 %) from stage II or III to stage IV. On the other hand, 23 patients (16 %) were downstaged by PET/CT, including 4 (3 %) from stage IV to stage II or III. PET/CT had a high or medium impact on management planning for 18 patients (13 %). Median follow-up was 30 months (range 9–59 months); 37 patients (26 %) experienced recurrence or progression of disease during follow-up and 17 patients (12 %) died. The Cox model indicated that CI staging was significantly associated with PFS (p = 0.01), but PET/CT staging provided stronger prognostic stratification (p < 0.0001). Moreover, Cox regression multivariate analysis showed that only PET/CT staging remained associated with PFS (p < 0.0001).

Conclusion

FDG PET/CT provides staging information that more accurately stratifies prognostic risk in newly diagnosed large BC when compared with conventional explorations alone.

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Title: 18F-FDG PET/CT provides powerful prognostic stratification in the primary staging of large breast cancer when compared with conventional explorations
Authors: Alexandre Cochet
Inna Dygai-Cochet
Jean-Marc Riedinger
Olivier Humbert
Alina Berriolo-Riedinger
Michel Toubeau
Séverine Guiu
Charles Coutant
Bruno Coudert
Pierre Fumoleau
François Brunotte
Publication date: 01-03-2014
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 3/2014
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-013-2595-4

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Springer Medicine

¹⁸F-FDG PET/CT provides powerful prognostic stratification in the primary staging of large breast cancer when compared with conventional explorations

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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