Diagnostic Performance of F18-FDG PET/CT in Male Breast Cancers Patients

Abstract

Introduction: F18-FDG PET/CT is the most important hybrid imaging used in the diagnostic, staging, follow-up, and treatment evaluation response in cancer patients. However, it is well-known that in breast cancer the use of F18-FDG is not included in the first line protocol of initial diagnostic, both in female and male breast cancer patients. F18-FDG PET/CT is a valuable tool to provide information on extra-axillary lymph node involvement, distant metastases, and other occult primary cancers. This study assesses F18-FDG PET/CT systemic staging in male patients with diagnosed breast cancer and determines detection rates for unsuspected distant metastases and synchronous malignancies. Methods: We analyzed a number of 170 male patients with breast cancer, seen between 2000–2020, in a tertiary center. From this group, between 2013–2020 a number of 23 patients underwent F18-FDG PET/CT. Rates of upstaging were determined for each case and the detection of other primary malignancies was analyzed. Results: Median age of male breast cancer group was 61.3 y (range, 34–85 y), most had intraductal carcinoma (82.4%) and unsuspected distant metastases, which increased patient stage to IV, observed in 27%. In 4 out 23 patients (17.4%), F18-FDG PET/CT identified synchronous cancers (2 prostate cancers, 1 thyroid and 1 colon cancer). Conclusion: F18-FDG PET/CT is a valuable tool to provide information on extra-axillary lymph node involvement, distant metastases, and other occult primary cancers. Baseline F18-FDG PET/CT has a substantial impact on the initial staging and on clinical management in male breast patients and should be considered for use in newly diagnosed patients.

Hemogram index parameters in the evaluation of male breast cancer and inflammatory response: a case-control study

“…The incidence of stage III/IV cancer at admission is >60% in Africa, <40% in North America and Western European countries, and between 40% and 60% in Eastern Europe and South America. The reasons for admission at later stages are reported to be race, low socioeconomic status, lack of awareness about the disease, and uncertainties in the characterization of highrisk patients for screening in the literature 8,[11][12][13][14][15][16][17] . In our study, the most common symptom was a breast mass, and 50% of them were at late stages at the time of diagnosis.…”

18F-FDG PET/CT for the evaluation of male breast cancer: a systematic review

“…This review is not without some limitations that can affect its quality: low sample of studies considered, high heterogeneity of patients and different setting for the use of 18 F-FDG PET/CT are the most relevant.…”

“…Regarding diagnostic performances of hybrid imaging for the assessment of MCB, data reported in literature revealed a sensitivity ranging from 95% to 100%, a specificity ranging from 80% to 67%, a PPV ranging from 91% to 86%, an NPV ranging from 89% to 100% and an accuracy ranging from 90% to 100%, depending on the study considered [21,22]. Several studies demonstrated the role of 18 F-FDG PET/CT for the initial assessment of MBC. In this setting, its utility was underlined in particular for the evaluation of the primary site of the disease and to reveal the presence of axillary and locoregional or distant nodal metastasis.…”

“…A wide literature search of the PubMed/MEDLINE, Scopus, Embase and Cochrane library databases was made to find significant published articles concerning the usefulness of 18 F-FDG PET/CT in the evaluation of MBC. The search algorithms used are as follows:…”

“…In this setting, the most frequent sites of localization of the disease revealed by hybrid imaging are nodes (supraclavicular, axillary and mediastinal), bone and lung. However, also liver, brain, adrenal glands or skin localization can be present [17,18]. F-FDG imaging for male breast cancer Dondi et al 127…”