Association between [18F]fluorodeoxyglucose uptake and prognostic parameters in breast cancer

Abstract

Positron emission tomography (PET) with [18F]fluorodeoxyglucose (FDG) is recognized to be an accurate, non-invasive imaging modality for the diagnosis and staging of many malignancies, including breast cancer. Studies performed on different cancers have shown that hypermetabolic tumours usually have a poorer prognosis than hypometabolic tumours1. Oshida and colleagues2 have reported that a high uptake of FDG in tumour tissue can serve as a risk factor for recurrence in women with breast cancer. There are various prognostic factors related to breast cancer. Some provide important information that can affect management, such as axillary lymph node status, presence of metastases, and oestrogen and progesterone receptor status. Others such as p53 immunoreactivity are relevant clinically, but are still not used routinely for risk stratification. Most factors can be assessed only after surgery1. Preoperative prediction of patient prognosis is becoming more important because an increasing number of women with breast cancer have neoadjuvant chemotherapy with the aim of downstaging their disease, and increasing the feasibility of breast-conserving surgery. It may also be possible to evaluate the chemosensitivity of the breast tumour; FDG–PET seems to be promising for this purpose3. FDG–PET before surgery may provide important information about tumour metabolism and its proliferation rate which could be of prognostic significance. Calculating FDGuptake bymeans of a simple method, the standardized uptake value (SUV), can be done before surgery, andmight be associated with the biological aggressiveness of breast cancer. The aim of this study was to determine the possible correlation between FDG uptake and well established prognostic markers in women with breast cancer.