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01-04-2013 | Original Article

Predictive value of FDG PET/CT for pathologic axillary node involvement after neoadjuvant chemotherapy

Authors: Bhumsuk Keam, Seock-Ah Im, Youngil Koh, Sae-Won Han, Do-Youn Oh, Nariya Cho, Jee Hyun Kim, Wonshik Han, Keon Wook Kang, Woo Kyung Moon, Tae-You Kim, In Ae Park, Dong-Young Noh, June-Key Chung, Yung-Jue Bang

Published in: Breast Cancer | Issue 2/2013

Abstract

Background

The purpose of this study was to determine the usefulness of sequential FDG PET/CTs for prediction of axillary lymph node (ALN) status after neoadjuvant chemotherapy (NAC).

Methods

Seventy-seven stage II or III breast cancer patients who received 3 cycles of neoadjuvant docetaxel/doxorubicin chemotherapy were enrolled in this prospective study. FDG PET/CTs were acquired before chemotherapy and after the first cycle of chemotherapy for early metabolic response prediction.

Results

Patients with pN0 had significantly lower post-NAC ALN standard uptake value (SUV) than those who were pN+ (1.22 ± 1.46 in pN0 vs. 2.13 ± 1.99 in pN+, P = 0.017). Post-NAC ALN size on CT also differed according to pathologic ALN status (6.3 mm in pN0 vs. 11.1 mm in pN+, P = 0.014). When serial FDG PET/CT and chest CT were used, patients with an SUV > 1.5 and post-NAC ALN size ≥10 mm on CT did not achieve pN0 (specificity 100% and positive predictive value 100%).

Conclusions

The serial FDG PET/CT after NAC could predict the pathologic status of ALN before surgery in stage II/III breast cancer. Our findings suggest that the combined use of serial FDG PET/CTs and chest CT might provide better information regarding ALN before surgery.

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Title: Predictive value of FDG PET/CT for pathologic axillary node involvement after neoadjuvant chemotherapy
Authors: Bhumsuk Keam
Seock-Ah Im
Youngil Koh
Sae-Won Han
Do-Youn Oh
Nariya Cho
Jee Hyun Kim
Wonshik Han
Keon Wook Kang
Woo Kyung Moon
Tae-You Kim
In Ae Park
Dong-Young Noh
June-Key Chung
Yung-Jue Bang
Publication date: 01-04-2013
Publisher: Springer Japan
Published in: Breast Cancer / Issue 2/2013
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI: https://doi.org/10.1007/s12282-011-0323-0

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Abstract

Background

Methods

Results

Conclusions

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