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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 8/2020

Open Access 01-08-2020 | Computed Tomography | Breast Oncology

Utility of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Fusion Imaging for Prediction of Metastasis to Sentinel and Nonsentinel Nodes in Patients with Clinically Node-Negative Breast Cancer

Authors: Yoji Yamagishi, MD, Tamio Yamasaki, MD, Jiro Ishida, MD, Tomoyuki Moriya, MD, Takahiro Einama, MD, Tomomi Koiwai, MD, Makiko Fukumura-Koga, MD, Takako Kono, MD, Katsumi Hayashi, MD, Hideki Ueno, MD, Junji Yamamoto, MD, Hitoshi Tsuda, MD

Published in: Annals of Surgical Oncology | Issue 8/2020

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Abstract

Purpose

18F-Fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) is an important diagnostic tool in breast cancer. The utility of maximum standardized uptake values (SUVmax) of primary tumors has been evaluated to predict sentinel node (SN) and non-SN metastasis in clinically node-negative (cN0) patients.

Patients and Methods

18F-FDG PET/CT was performed on 414 cN0 patients. The following parameters were evaluated: SUVmax at 60 min (SUVmax1), SUVmax at 120 min (SUVmax2), percent change between SUVmax1 and SUVmax2 (ΔSUVmax%), SN metastasis foci maximum size (SN meta size), and ratio of metastatic SNs to total SNs or SN ratio (SNR). It was assessed whether these were risk factors for SN metastasis. The relationship between these parameters and the status of SN and/or non-SN metastasis was retrospectively explored to predict non-SN metastasis.

Results

All SUV parameters significantly correlated with pathological T factor (pT), nuclear grade, lymphatic invasion (Ly), and Ki-67 labeling index. On multivariate analysis, pT and Ly were independent predictive factors for SN metastasis. In SN meta-positive cases, SN meta size, SNR, and ΔSUVmax% were predictors for non-SN metastasis on univariate analyses, and the former two were independent predictors on multivariate analysis. The combination of SUVmax2 and ΔSUVmax% was an independent predictor of non-SN metastasis (P = 0.0312) and was associated with prediction of non-SN metastasis negative status with high probability (92.3%).

Conclusions

In patients with cN0 breast cancer, SUV parameters of the primary tumor were correlated with pathological features. The combination of SUVmax2 and ΔSUVmax% may be useful for predicting non-SN metastasis.
Appendix
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Literature
1.
Hori M, Matsuda T, Shibata A, Katanoda K, Sobue T, Nishimoto H. Cancer incidence and incidence rates in Japan in 2009: a study of 32 population-based cancer registries for the monitoring of cancer incidence in Japan (MCIJ) project. Jpn J Clin Oncol. 2015;45:884–91.CrossRef
2.
Fuster D, Duch J, Paredes P, et al. Preoperative staging of large primary breast cancer with [18F]fluorodeoxyglucose positron emission tomography/computed tomography compared with conventional imaging procedures. J Clin Oncol. 2008;26:4746–51.CrossRef
3.
Groheux D, Hindie E, Delord M, et al. Prognostic impact of (18)FDG-PET-CT findings in clinical stage III and IIB breast cancer. J Natl Cancer Inst. 2012;104:1879–87.CrossRef
4.
Groheux D, Giacchetti S, Moretti JL, et al. Correlation of high 18F-FDG uptake to clinical, pathological and biological prognostic factors in breast cancer. Eur J Nucl Med Mol Imaging. 2011;38:426–35.CrossRef
5.
Soussan M, Orlhac F, Boubaya M, et al. Relationship between tumor heterogeneity measured on FDG-PET/CT and pathological prognostic factors in invasive breast cancer. PLoS ONE. 2014;9:e94017.CrossRef
6.
Son SH, Kim DH, Hong CM, et al. Prognostic implication of intratumoral metabolic heterogeneity in invasive ductal carcinoma of the breast. BMC Cancer. 2014;14:585.CrossRef
7.
Aogi K, Kadoya T, Sugawara Y, et al. Utility of (18)F FDG-PET/CT for predicting prognosis of luminal-type breast cancer. Breast Cancer Res Treat. 2015;150:209–17.CrossRef
8.
Matthies A, Hickeson M, Cuchiara A, Alavi A. Dual time point 18F-FDG PET for the evaluation of pulmonary nodules. J Nucl Med. 2002;43:871–5.PubMed
9.
Hamberg LM, Hunter GJ, Alpert NM, Choi NC, Babich JW, Fischman AJ. The dose uptake ratio as an index of glucose metabolism: useful parameter or oversimplification? J Nucl Med. 1994;35:1308–12.PubMed
10.
Kaida H, Azuma K, Toh U, et al. Correlations between dual-phase 18F-FDG uptake and clinicopathologic and biological markers of breast cancer. Hell J Nucl Med. 2018;21:35–42.PubMed
11.
Lyman GH, Somerfield MR, Bosserman LD, Perkins CL, Weaver DL, Giuliano AE. Sentinel lymph node biopsy for patients with early-stage breast cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2017;35:561–4.CrossRef
12.
Canavese G, Gipponi M, Catturich A, et al. Technical issues and pathologic implications of sentinel lymph node biopsy in early-stage breast cancer patients. J Surg Oncol. 2001;77:81–7.CrossRef
13.
Chagpar AB, Scoggins CR, Martin RC 2nd, et al. Prediction of sentinel lymph node-only disease in women with invasive breast cancer. Am J Surg. 2006;192:882–7.CrossRef
14.
Giuliano AE, Hunt KK, Ballman KV, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305:569–75.CrossRef
15.
Bevilacqua JL, Kattan MW, Fey JV, Cody HS 3rd, Borgen PI, Van Zee KJ. Doctor, what are my chances of having a positive sentinel node? A validated nomogram for risk estimation. J Clin Oncol. 2007;25:3670–9.CrossRef
16.
Lambert LA, Ayers GD, Meric-Bernstam F. Validation of a breast cancer nomogram for predicting nonsentinel lymph node metastases after a positive sentinel node biopsy. Ann Surg Oncol. 2007;14:2422–3.CrossRef
17.
Sasada T, Kataoka T, Shigematsu H, et al. Three models for predicting the risk of non-sentinel lymph node metastasis in Japanese breast cancer patients. Breast Cancer. 2014;21:571–5.CrossRef
18.
Tsuda H, Akiyama F, Kurosumi M, Sakamoto G, Watanabe T. Establishment of histological criteria for high-risk node-negative breast carcinoma for a multi-institutional randomized clinical trial of adjuvant therapy. Japan National Surgical Adjuvant Study of Breast Cancer (NSAS-BC) Pathology Section. Jpn J Clin Oncol. 1998;28:486–91.CrossRef
19.
Hammond ME, Hayes DF, Dowsett M, et al. American Society of Clinical Oncology/College Of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol. 2010;28:2784–95.CrossRef
20.
Wolff AC, Hammond ME, Hicks DG, et al. Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update. J Clin Oncol. 2013;31:3997–4013.CrossRef
21.
Dowsett M, Nielsen TO, A’Hern R, et al. Assessment of Ki67 in breast cancer: recommendations from the International Ki67 in Breast Cancer working group. J Natl Cancer Inst. 2011;103:1656–64.CrossRef
22.
Cheang MC, Chia SK, Voduc D, et al. Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl Cancer Inst. 2009;101:736–50.CrossRef
23.
Van Zee KJ, Manasseh DM, Bevilacqua JL, et al. A nomogram for predicting the likelihood of additional nodal metastases in breast cancer patients with a positive sentinel node biopsy. Ann Surg Oncol. 2003;10:1140–51.CrossRef
24.
Turner RR, Chu KU, Qi K, et al. Pathologic features associated with nonsentinel lymph node metastases in patients with metastatic breast carcinoma in a sentinel lymph node. Cancer. 2000;89:574–81.CrossRef
25.
Jinno H, Sakata M, Asaga S, et al. Predictors to assess non-sentinel lymph node status in breast cancer patients with sentinel lymph node metastasis. Breast J. 2008;14:551–5.CrossRef
26.
Viale G, Maiorano E, Pruneri G, et al. Predicting the risk for additional axillary metastases in patients with breast carcinoma and positive sentinel lymph node biopsy. Ann Surg. 2005;241:319–25.CrossRef
27.
Donker M, van Tienhoven G, Straver ME, et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol. 2014;15:1303–10.CrossRef
Metadata
Title
Utility of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Fusion Imaging for Prediction of Metastasis to Sentinel and Nonsentinel Nodes in Patients with Clinically Node-Negative Breast Cancer
Authors
Yoji Yamagishi, MD
Tamio Yamasaki, MD
Jiro Ishida, MD
Tomoyuki Moriya, MD
Takahiro Einama, MD
Tomomi Koiwai, MD
Makiko Fukumura-Koga, MD
Takako Kono, MD
Katsumi Hayashi, MD
Hideki Ueno, MD
Junji Yamamoto, MD
Hitoshi Tsuda, MD
Publication date
01-08-2020
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 8/2020
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-08269-0

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