Prognostic Impact of 18FDG-PET-CT Findings in Clinical Stage III and IIB Breast Cancer

Groheux, David; Hindié, Elif; Delord, Marc; Giacchetti, Sylvie; Hamy, Anne-Sophie; Bazelaire, Cédric de; Roquancourt, Anne de; Vercellino, Laëtitia; Toubert, Marie‐Elisabeth; Merlet, Pascal; Espié, Marc

doi:10.1093/jnci/djs451

Cited by 136 publications

(122 citation statements)

References 27 publications

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“…We observed that extra-axillary lymph nodes were more frequent in patients with grade 3 tumours in comparison with lower grades (29% vs. 13%, P = 0.004) but the rate of distant metastases did not differ (17% vs. 21%, P = 0.418) [11].…”

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confidence: 57%

“…The larger evaluations have been performed in locally advanced and inflammatory BC [6][7][8] which are usually regarded as equivalent to stage III cancer of the AJCC classification [9]. More recent studies have suggested that PET/CT could also be valuable in stage II patients, especially in stage IIB [2,10,11]. In 254 patients with BC of mixed phenotypes, we detected distant metastases with PET/CT in 2.3% (1/44) of clinical stage IIA, 10.7% (6/56) of stage IIB, 17.5% (11/63) of stage IIIA, 36.5% (27/ 74) of stage IIIB and 47.1% (8/17) of stage IIIC patients [11].…”

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confidence: 99%

“…More recent studies have suggested that PET/CT could also be valuable in stage II patients, especially in stage IIB [2,10,11]. In 254 patients with BC of mixed phenotypes, we detected distant metastases with PET/CT in 2.3% (1/44) of clinical stage IIA, 10.7% (6/56) of stage IIB, 17.5% (11/63) of stage IIIA, 36.5% (27/ 74) of stage IIIB and 47.1% (8/17) of stage IIIC patients [11]. Among 189 patients with clinical stage IIB or higher and adequate follow-up, disease-specific survival was significantly shorter in the 47 patients which scored M1 on 18FDG-PET/ CT in comparison to M0 patients, with a 3-year disease-specific survival of 57% vs 88% (P < 0.001) [11].…”

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confidence: 99%

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FDG-PET/CT for systemic staging of patients with newly diagnosed breast cancer

Groheux

2017

Eur J Nucl Med Mol Imaging

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FDG-PET/CT for systemic staging of patients with newly diagnosed breast cancer

Groheux

2017

Eur J Nucl Med Mol Imaging

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“…7 Also, an early change in 18 F-FDG uptake is a potential predictive biomarker of response to NAC. [8][9][10][11][12] However, at baseline, as demonstrated in recent studies, ER-positive tumors are usually characterized by rather low standardized uptake values (SUVs) because of lower 18 F-FDG uptake compared with other breast cancer phenotypes.…”

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confidence: 99%

Estrogen receptor‐positive/human epidermal growth factor receptor 2‐negative breast tumors

Groheux

Hatt

Hindié

et al. 2013

Cancer

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BACKGROUND:The objective of this prospective study was to evaluate the ability of 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) to predict chemosensitivity in patients with estrogen receptor (ER)-positive/ human epidermal growth factor receptor 2 (HER2)-negative breast cancer. METHODS: Sixty-four consecutive patients underwent 18 F-FDG PET/CT scanning at baseline and after the second course of neoadjuvant chemotherapy (NAC). The evolution (D) between the 2 scans of image parameters (maximum standardized uptake value [SUV max ], SUV mean , metabolic tumor volume, and total lesion glycolysis [TLG]) was measured. Correlations between early changes in PET-derived parameters and pathologic response observed in surgical specimens after the completion of 8 courses of NAC were estimated with Mann-Whitney U tests. Response prediction on the basis of clinical data, histologic type, or molecular markers also was assessed (Fisher exact test). Receiver operating characteristic (ROC) analysis was used to compare the area under the curve (AUC) of each parameter. RESULTS: The best prediction of chemosensitivity was obtained with DTLG (À49% AE 31% in nonresponders vs À73% AE 25% in responders; P <.0001). Among the biologic parameters, only negative progesterone receptor status (57% responders vs 31% nonresponders; P ¼.04) and luminal B subtype (63% responders vs 22% nonresponders; P ¼.02) were predictive of a pathologic response. ROC analysis resulted in an AUC of 0.81, 0.73, 0.71, and 0.63 for DTLG, DSUV max , luminal subtype, and progesterone receptor status, respectively. CONCLUSIONS: When patients responded to NAC, the majority of ER-positive/HER2 negative tumors exhibited partial tumor shrinkage; and the PET parameters that combined volume and activity measurements, such as TLG, offered better accuracy for early prediction than the SUV max . Negative progesterone receptor status and luminal B subtype had weaker predictive power than PET-derived parameters. Cancer KEYWORDS: 18 F-fluorodeoxyglucose, positron emission tomography/computed tomography, maximum standardized uptake value, total lesion glycolysis, estrogen receptor-positive/human epidermal growth factor receptor 2 negative breast cancer, luminal tumor, neoadjuvant chemotherapy, metabolic response, pathologic response, chemosensitivity. INTRODUCTIONNeoadjuvant chemotherapy (NAC) is commonly offered to patients with locally advanced breast cancer and to women with primary operable but large breast cancer. This strategy allows more patients to undergo breast-conserving surgery and provides information on the efficacy of chemotherapy. Breast carcinoma is a heterogeneous class of tumors, and gene-expression profiling has led to the identification of 5 different subtypes with clinical implications (ie, luminal A, luminal B, basal-like, human epidermal growth factor receptor 2 [HER2]-like, and normal-like subtypes). 1 To some degree, these molecular subtypes can be distinguished using immunohistochemistry. 2 Estrogen receptor...

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“…On the contrary, PET/CT is currently used for the staging of stage IIB and stage III locally advanced breast cancer (LABC) [12][13][14][15]. Additional information that can be gained from baseline SUV of the primary tumour can be of interest.…”

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confidence: 99%