Physiologic and hypermetabolic breast 18-F FDG uptake on PET/CT during lactation

Nissan, Noam; Sandler, Israel; Eifer, Michal; Eshet, Yael; Davidson, Tima; Bernstine, Hanna; Groshar, David; Sklair‐Levy, Miri; Domachevsky, Liran

doi:10.1007/s00330-020-07081-4

Cited by 10 publications

(7 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indeed, despite being possible, lactation competence (37), as well as BPE occurrence (38), are both known to be markedly reduced in the irradiated breast, and therefore, an ipsi-lateral absence of CAD coloring may be intuitively anticipated. On the other hand, although rare, lactation BPE cannot be ruled out based on unilateral coloring, in agreement with a recent report on the lactating breast parenchymal 18 F-Fluoro-deoxy-glucose (FDG) uptake on PET/CT, which typically, but not exclusively, manifests bilaterally (39). Overall, further laboratory and behavioral factors, such as hormonal levels and breastfeeding habits (eg, amount, frequency, dominant breast) are necessary to achieve better clustering and recognition of lactation BPE patterns, though they are likely impractical to maintain in reallife clinical practice, as was the settings of the present study.…”

Section: Discussionsupporting

confidence: 88%

MRI of the Lactating Breast: Computer-Aided Diagnosis False Positive Rates and Background Parenchymal Enhancement Kinetic Features

et al. 2022

Self Cite

View full text Add to dashboard Cite

Rationale and Objectives: To investigate the application of computer-added diagnosis (CAD) in dynamic contrast-enhanced (DCE) MRI of the healthy lactating breast, focusing on false-positive rates and background parenchymal enhancement (BPE) coloring patterns in comparison with breast cancer features in non-lactating patients. Materials and Methods:The study population was composed of 58 healthy lactating patients and control groups of 113 healthy premenopausal non-lactating patients and 55 premenopausal non-lactating patients with newly-diagnosed breast cancer. Patients were scanned on 1.5-T MRI using conventional DCE protocol. A retrospective analysis of DCE-derived CAD properties was conducted using a commercial software that is regularly utilized in our routine radiological work-up. Qualitative morphological characterization and automaticallyobtained quantitative parametric measurements of the BPE-induced CAD coloring were categorized and subgroups' trends and differences between the lactating and cancer cohorts were statistically assessed.Results: CAD false-positive coloring was found in the majority of lactating cases (87%). Lactation BPE coloring was characteristically non-mass enhancement (NME)-like shaped (87%), bilateral (79%) and symmetric (64%), whereas, unilateral coloring was associated with prior irradiation (p <0.0001). Inter-individual variability in CAD appearance of both scoring-grade and kinetic-curve dominance was found among the lactating cohort. When compared with healthy non-lactating controls, CAD false positive probability was significantly increased [Odds ratio 40.2, p <0001], while in comparison with the breast cancer cohort, CAD features were mostly inconclusive, even though increased size parameters were significantly associated with lactation-BPE (p <0.00001).Conclusion: BPE was identified as a common source for false-positive CAD coloring on breast DCE-MRI among lactating population. Despite several typical characteristics, overlapping features with breast malignancy warrant a careful evaluation and clinical correlation in all cases with suspected lactation induced CAD coloring.

show abstract

Section: Discussionsupporting

confidence: 88%

MRI of the Lactating Breast: Computer-Aided Diagnosis False Positive Rates and Background Parenchymal Enhancement Kinetic Features

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…The physiological 18F-FDG uptake values for the normal lactating breast parenchyma of PABC patients were significantly decreased in comparison with physiological 18F-FDG uptake values measured in the control group, including those patients who had active malignant diseases other than breast cancer. 1 However, the relationship between breastfeeding cessation or dopamine administration and 18F-FDG uptake in the mammary gland has not been investigated. Decreased milk synthesis due to decreased prolactin levels may have resulted in decreased 18F-FDG uptake and decreased MRI enhancement in the background breast tissue.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…During pregnancy and lactation, prolactin levels increase, which stimulates breast growth in preparation for milk production, resulting in hypermetabolism of breast tissues and making it difficult to interpret 18F-FDG PET/CT images because the accumulation of noncancerous tissue increases. 1 Cabergoline, a dopamine receptor agonist used in the treatment of hyperprolactinemia, directly stimulates D2dopamine receptors in the anterior pituitary gland, which suppresses prolactin production. For breast cancer during lactation, it is recommended to stop lactation in advance by taking a single 1-mg oral dose of cabergoline before surgery.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A case of breast cancer: Suppression of lactation-related FDG uptake 2 days after cabergoline administration

Kuroda

Yoshizako

Yamamoto

et al. 2023

Acta Radiologica Open

View full text Add to dashboard Cite

We present a case of a 35-year-old woman with breast cancer in lactation 3 months after childbirth, in which a lactation inhibitor was useful for 18F-FDG PET/CT examination. Via ultrasonography and biopsy with histopathology, we diagnosed the lesion in the upper region of the left breast as invasive ductal carcinoma. She stopped breastfeeding and was administered cabergoline to suppress lactation. Two days after the administration, 18F-FDG PET/CT revealed segmental uptake (10 cm in diameter) and no lactation-related uptakes. Dynamic MRI also revealed a segmental enhancement of the same size as 18F-FDG PET/CT. The lactation inhibitor was useful to delineate the extent of the lesion during the 18F-FDG PET/CT examination.

show abstract

“…A low level of symmetric, diffuse uptake is a normal physiologic pattern in the breast, whereas focal uptake above background of bilateral breast tissue may indicate presence of malignancy [ 103 ]. FDG background uptake in the breasts is generally increased among lactating individuals compared with non-lactating individuals ( Figure 17 ) [ 104 ]. Fat necrosis is metabolically active and can remain so indefinitely.…”

Section: Breast Cancermentioning

confidence: 99%

PET-CT in Clinical Adult Oncology: II. Primary Thoracic and Breast Malignancies

Covington

Koppula

Fine

et al. 2022

Cancers

View full text Add to dashboard Cite

Positron emission tomography combined with x-ray computed tomography (PET-CT) is an advanced imaging modality with oncologic applications that include staging, therapy assessment, restaging, and surveillance. This six-part series of review articles provides practical information to providers and imaging professionals regarding the best use of PET-CT for the more common adult malignancies. The second article of this series addresses primary thoracic malignancy and breast cancer. For primary thoracic malignancy, the focus will be on lung cancer, malignant pleural mesothelioma, thymoma, and thymic carcinoma, with an emphasis on the use of FDG PET-CT. For breast cancer, the various histologic subtypes will be addressed, and will include 18F fluorodeoxyglucose (FDG), recently Food and Drug Administration (FDA)-approved 18F-fluoroestradiol (FES), and 18F sodium fluoride (NaF). The pitfalls and nuances of PET-CT in breast and primary thoracic malignancies and the imaging features that distinguish between subcategories of these tumors are addressed. This review will serve as a resource for the appropriate roles and limitations of PET-CT in the clinical management of patients with breast and primary thoracic malignancies for healthcare professionals caring for adult patients with these cancers. It also serves as a practical guide for imaging providers, including radiologists, nuclear medicine physicians, and their trainees.

show abstract

Physiologic and hypermetabolic breast 18-F FDG uptake on PET/CT during lactation

Cited by 10 publications

References 35 publications

MRI of the Lactating Breast: Computer-Aided Diagnosis False Positive Rates and Background Parenchymal Enhancement Kinetic Features

MRI of the Lactating Breast: Computer-Aided Diagnosis False Positive Rates and Background Parenchymal Enhancement Kinetic Features

A case of breast cancer: Suppression of lactation-related FDG uptake 2 days after cabergoline administration

PET-CT in Clinical Adult Oncology: II. Primary Thoracic and Breast Malignancies

Contact Info

Product

Resources

About