The Role of 18F-FDG PET/CT in Evaluating Elevated Levels of Tumor Markers in Breast Cancer

Göktaş, İnan; Cayvarlı, Hakan

doi:10.4274/mirt.74436

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…Several studies have shown that elevation of serum tumour markers occurs significantly in advance of diagnosis of BC recurrence using radiodiagnostic methods (15,16). This is why some authors recommend the use of a combination of several tumour markers, especially CEA, CA 15-3 and cytokeratins, to increase the sensitivity of relapse detection, namely every 3 months after surgery during the first 5 years and every 6 months thereafter (17,18).…”

Section: Discussionmentioning

confidence: 99%

Perioperative Tumour Marker Levels as Prognostic Factors for Surgical Treatment of Breast Cancer Liver Metastases

Třeška¹,

Topolčan²,

Zoubkova³

et al. 2018

Anticancer Res

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Abstract. Background RFS (p<0.04; p<0.01; p<0.02), while CA19-9 postoperative levels were significant for OS and RFS (p<0.03; p<0.01 Breast cancer (BC) represents the most frequent cancer worldwide among women and is one of the most frequent causes of death in this population. BC metastases either develop concomitantly with the primary BC or at different time intervals in more than 50% of women with BC. Breast cancer liver metastases (BCLM) in most women are associated with concurrent BC dissemination to the lungs and bones and these represent the only site of metastatic BC in 12-15% women. Although great progress has been made in the diagnosis and effective treatment of BC, metastases develop in 30% of women despite timely diagnosis and radical treatment (1, 2).Surgical treatment of BCLM is an important component of multimodal therapeutic approaches. However, its results remain suboptimal compared, for example, to patients with colorectal cancer liver metastases. In our view, one strategy that might improve the results of surgical management of BCLM is the search for early indicators of tumour dissemination or for prognostically high-risk patients.Tumour markers are general indicators used in monitoring and follow-up of patients. The most frequently used markers to monitor treatment efficacy and diagnose BCLM recurrence include mucins, such as carbohydrate antigen CA 19-9, cytokeratins such as tissue polypeptide antigen (TPA) and tissue-specific polypeptide antigen (TPS), proliferation markers such as thymidine kinase (TK) and carcinoembryonic antigen (CEA). However, no study regarding the prognostic significance of preoperative serum tumour marker levels in patients undergoing surgery for BCLM has been published to date, as far as we are aware.The aim of our retrospective study was to determine whether perioperative levels of clinically routinely used tumour markers influence overall survival (OS) and recurrence-free survival (RFS) of patients undergoing resection or thermoablative therapy for BCLM as part of a multimodal approach. Patients and MethodsFrom January 1, 2000 until January 1, 2018, a total of 32 women underwent surgery for BCLM at the Department of Surgery, University Hospital in Pilsen, Czech Republic. Surgery was indicated in women in a general good state of health from the aspect of surgery and those who had consented to undergo the proposed surgical procedure. Surgery was indicated only if the metastases were located solely within the liver parenchyma. Every patient underwent hybrid imaging using positron-emission tomography (PET) and computed tomography (CT) or PET and magnetic resonance imaging (MRI) before surgery. Another requirement was that the future liver remnant volume exceed 30% of the total liver volume. The average age of these women was 49.5±10.7 years. The primary BC types were: ductal in 20 cases, lobular in seven, erysipeloid in four, and sarcomatoid (spindle cell) carcinoma in one. The average interval between initial breast surgery and BCLM surgery was 4.7±3.7 years.

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Section: Discussionmentioning

confidence: 99%

Perioperative Tumour Marker Levels as Prognostic Factors for Surgical Treatment of Breast Cancer Liver Metastases

Třeška¹,

Topolčan²,

Zoubkova³

et al. 2018

Anticancer Res

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“…obtained 66% sensitivity with CA15.3, CEA and CA125 in the detection of metastases, with 20% false positives [ 26 ]. Similarly, Göktas and Cayvarli observed a positive predictive value (PPV) for CA15.3 of 77% [ 27 ].…”

Section: Clinical Utility Of Circulating Tms In Breast Cancermentioning

confidence: 99%

Consensus of the Spanish society of laboratory medicine and the Spanish society of medical oncology on the methodology and criteria for evaluation of circulating tumour markers in breast cancer

et al. 2021

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The measurement of circulating tumour markers (TMs) for the diagnosis or monitoring of breast cancer has sometimes been considered of limited utility. In addition to the overinterpretation of irrelevant changes in marker levels, the characteristics of the patient, the disease or other pathologies that can modify them are often not considered in their evaluation. On the other hand, there are recent data on the relationship of TMs with molecular subtypes and on their prognostic value, the knowledge of which may improve their clinical utility. This consensus article arises from a collaboration between the Spanish Society of Laboratory Medicine (SEQCML) and the Spanish Society of Medical Oncology (SEOM). It aims to improve the use and interpretation of circulating TMs in breast cancer. The text summarizes the current knowledge and available evidence on the subject and proposes a series of recommendations mainly focussed on the indication, the frequency of testing and the factors that should be considered for correctly interpreting changes in the levels of TMs.

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“…Commonly evaluated tumor markers in breast cancer disease have been an emphasis in multi-center studies attempting to correlate the level of tumor markers to cancer recurrence. However, in patients with early disease burden 18 FDG-PET/CT demonstrates significant accuracy in assessing the site and extent of recurrence when confronted with elevated serum tumor markers in asymptomatic breast cancer patients following primary treatment ( 8 - 13 ). This event may be due in part from the lack of tumor marker level increase before clinical or radiological findings of recurrence ( 14 , 15 ).…”

Section: Introductionmentioning

confidence: 99%

“…Retrospective studies have revealed that serial measurements of CA 15-3, up to nine months before 18 FDG-PET/CT evaluation in relapsed breast cancer patients, correlated with positive 18 FDG-PET/CT findings that confirmed the cancer recurrence ( 18 ). Although promising data has been presented, the value of 18 FDG-PET/CT in evaluating breast cancer recurrence with elevated tumor markers remains unclear ( 2 , 8 - 12 ).…”

Section: Introductionmentioning

confidence: 99%

Examining the evolving utility of 18FDG-PET/CT in breast cancer recurrence

Djassemi¹,

Rampey²,

Motiani³

2020

Transl Cancer Res TCR

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Many studies have demonstrated the utility of 18 fluorodeoxyglucose-positron emission tomography/computed tomography ( 18 FDG-PET/CT) scan in evaluating breast cancer recurrence in subsets of patients based on age, histological subtype and cancer stage to guide response to conventional chemoradiation guidelines during treatment of metastatic breast cancer disease. This literature review focuses on the breakthrough of 18 FDG-PET/CT imaging within the paradigm of breast cancer oncology centered toward improving risk stratification and prognostication of disease relapse based on cancer molecular phenotypes, tumor markers, early metabolic activity and response to neoadjuvant chemotherapy (NAC). The authors consider the rapid shift toward biomarker based molecular tracers to quantify treatment response and pathologic complete response with more recent imaging modalities such as dedicated breast positron emission tomography (dbPET), and the advantages afforded by this multisystem approach.

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The Role of 18F-FDG PET/CT in Evaluating Elevated Levels of Tumor Markers in Breast Cancer

Cited by 5 publications

References 17 publications

Perioperative Tumour Marker Levels as Prognostic Factors for Surgical Treatment of Breast Cancer Liver Metastases

Perioperative Tumour Marker Levels as Prognostic Factors for Surgical Treatment of Breast Cancer Liver Metastases

Consensus of the Spanish society of laboratory medicine and the Spanish society of medical oncology on the methodology and criteria for evaluation of circulating tumour markers in breast cancer

Examining the evolving utility of 18FDG-PET/CT in breast cancer recurrence

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