01-11-2015 | Editorial Commentary
Concerning pretreatment 18F-FDG PET/CT imaging in patients with large or locally advanced breast cancer
Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 12/2015
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In this issue of the European Journal of Nuclear Medicine and Molecular Imaging, García Vicente and colleagues report on the role of 18F-FDG PET/CT in patients with clinical stage II or III breast cancer (BC). Following PET/CT imaging, the new metabolic stage was stage IV in 38 out of 198 patients (19 %). This had a major prognostic impact. The hazard ratio for death from BC (overall survival) was 0.117 for stage II vs. metabolic stage IV and 0.28 for stage III vs. metabolic stage IV [1]. Although the title of the study refers to locally advanced BC, about half of the included patients had clinical stage II disease [1]. Locally advanced BC is variably defined in the literature; some recommendations such as that of the National Comprehensive Cancer Network refers to patients with N2, N3 or T4 disease, i.e. AJCC clinical stages IIIA (excluding T3N1), IIIB and IIIC (Table 1) [2, 3].
AJCC stage
|
TNM
|
NCCN
|
||
---|---|---|---|---|
I
|
T1
|
N0
|
M0
|
Primary operable breast cancer
|
IIA
|
T0
|
N1
|
M0
|
|
T1
|
N1
|
M0
|
||
T2
|
N0
|
M0
|
||
IIB
|
T2
|
N1
|
M0
|
|
T3
|
N0
|
M0
|
||
IIIA
|
T3
|
N1
|
M0
|
|
T0
|
N2
|
M0
|
Locally advanced breast cancer
|
|
T1
|
N2
|
M0
|
||
T2
|
N2
|
M0
|
||
T3
|
N2
|
M0
|
||
IIIB
|
T4
|
N0
|
M0
|
|
T4
|
N1
|
M0
|
||
T4
|
N2
|
M0
|
||
IIIC
|
Any T
|
N3
|
M0
|
|
IV
|
Any T
|
Any N
|
M1
|
Metastatic disease
|