Diagnostic Value of FDG PET/CT in Surveillance after Curative Resection of Breast Cancer

Abstract

With increasing incidence of breast cancer and improvement in treatment, the concern about surveillance management also has increased. This retrospective study was designed to evaluate the diagnostic value of routine surveillance FDG PET/CT in patients with breast cancer. The diagnostic performance of surveillance PET/CT was analyzed regarding sensitivity, specificity, positive predictive value, negative predictive value and accuracy. The diagnostic accuracy was defined as the ability to differentiate recurrence and no-disease correctly and the proportion of true results, either true positive or true negative, in the population. Findings from pathologic examination; other imaging modalities such as CT, MRI and bone scan; or clinical follow-up were used as the reference standard. In this study of 1681 consecutive patients with breast cancer who underwent curative surgery, surveillance fluorodeoxyglucose PET/CT showed good diagnostic performance in the detection of clinically unexpected recurrent breast cancer or other malignancy, with a sensitivity of 100%, specificity of 98.5%, positive predictive value of 70.5%, negative predictive value of 100% and accuracy of 98.5%. In conclusion, surveillance fluorodeoxyglucose PET/CT showed good diagnostic performance in the detection of clinically unexpected recurrent breast cancer after curative surgery.

PET Molecular Imaging in Breast Cancer: Current Applications and Future Perspectives

“…Current guidelines recommend against routine FDG PET/CT imaging for surveillance of BC in asymptomatic patients due to cost and insufficient evidence; however, this may change. A recent retrospective study published in 2023 with 1681 patients suggests that surveillance PET/CT has an excellent diagnostic performance in detecting clinically unexpected recurrent BC after curative resection [ 61 ]. However, further studies, including randomized clinical trials, are needed to assess the cost-effectiveness and survival benefits of routine surveillance PET/CT.…”