Differences in Tumour Aggressiveness Based on Molecular Subtype and Race Measured by [18F]FDG PET Metabolic Metrics in Patients with Invasive Carcinoma of the Breast

Abstract

Breast cancer in women of African descent tends to be more aggressive with poorer prognosis. This is irrespective of the molecular subtype. [18F]FDG PET/CT metrics correlate with breast cancer aggressiveness based on molecular subtype. This study investigated the differences in [18F]FDG PET/CT metrics of locally advanced invasive ductal carcinoma (IDC) among different racial groups and molecular subtypes. Qualitative and semiquantitative readings of [18F]FDG PET/CT acquired in women with locally advanced IDC were performed. Biodata including self-identified racial grouping and histopathological data of the primary breast cancer were retrieved. Statistical analysis for differences in SUVmax, MTV and TLG of the primary tumour and the presence of regional and distant metastases was conducted based on molecular subtype and race. The primary tumour SUVmax, MTV, TLG and the prevalence of distant metastases were significantly higher in Black patients compared with other races (p < 0.05). The primary tumour SUVmax and presence of distant metastases in the luminal subtype and the primary tumour SUVmax and TLG in the basal subtype were significantly higher in Black patients compared with other races (p < 0.05). The significantly higher PET parameters in Black patients with IDC in general and in those with luminal and basal carcinoma subtypes suggest a more aggressive disease phenotype in this race.

The Utility of 18F-FDG-PET–CT Metabolic Parameters in Evaluating the Primary Tumor Aggressiveness and Lymph Node Metastasis of Nasopharyngeal Carcinoma

“…Therefore, as a tumor becomes increasingly undifferentiated and aggressive, it results in elevated glucose utilization and increased uptake of the radioactive tracer 18 F-FDG. 19 , 20 Black patients with breast cancer have poorer prognosis and higher mortality. Abubakar et al 19 observed differences in 18 F-FDG PET–CT metabolic parameters of locally advanced invasive ductal carcinoma (IDC) among patients of different racial groups and molecular subtypes.…”

“… 19 , 20 Black patients with breast cancer have poorer prognosis and higher mortality. Abubakar et al 19 observed differences in 18 F-FDG PET–CT metabolic parameters of locally advanced invasive ductal carcinoma (IDC) among patients of different racial groups and molecular subtypes. A notable increase in the SUV max , MTV, and TLG values of the primary tumor was observed in black patients when compared with patients of other ethnicities.…”

“…Overall, Black patients with IDC exhibited markedly elevated PET parameters, implying a more aggressive disease phenotype for this racial group, particularly with luminal and basal carcinoma subtypes. 19 …”

“…18 F-FDG PET–CT parameters offer metabolic information that can be used to evaluate tumor aggressiveness, 18 - 20 predict lymph node metastasis (LNM) 21 - 23 and may be correlated with patient survival. 24 The maximum standard uptake value (SUV max ) is the most commonly used metabolic parameter.…”