Tumour 18 F-FDG Uptake on preoperative PET/CT may predict axillary lymph node metastasis in ER-positive/HER2-negative and HER2-positive breast cancer subtypes

Abstract

• Tumour SUVmax could be an imaging biomarker for predicting ALNM • Tumour SUVmax predicting ALNM is effective in ER-positive/HER2-negative and HER2-positive subtypes • Tumour SUVmax predicting ALNM is inaccurate in triple-negative subtypes • Accurate prognostic prediction based on molecular subtype may facilitate individualized management.

The value of primary tumor 18F-FDG uptake on preoperative PET/CT for predicting intratumoral lymphatic invasion and axillary nodal metastasis

“…This group did not directly perform a visual or semiquantitative analysis of axillary LNs in their study. In the present study, lymphatic invasion was a statistically significant risk factor for axillary LN metastasis, which is consistent with the results of previous studies [1,10,11,13,14]. The mean SUV max of the primary tumors in this series correlated well with lymphatic invasion and with axillary LN metastasis, which is consistent with some previous studies [15][16][17] but contrasts with the results of other studies [8,13,18].…”

“…Van der Hoeven et al [8] showed that the sensitivity of FDG PET was a function of axillary tumor load and of the FDG avidity of the primary tumor; however, the latter was related to the detection rate of axillary metastasis but not to histopathological N status. Previous studies have shown that tumor size is independently associated with axillary LN metastasis [11,14]. In the present study, tumor size correlated with LN metastasis in the univariate analysis but not in the multivariate analysis.…”

“…On the other hand, the ability of primary tumor SUV max to predict axillary LN metastasis provides more objective preoperative validity. In a recent study [14], Kim et al demonstrated that high tumor FDG uptake in preoperative PET/CT, large tumor size and the presence of lymphovascular invasion were significantly associated with axillary LN metastasis in a multivariate logistic regression. This group did not directly perform a visual or semiquantitative analysis of axillary LNs in their study.…”

Basal 18 F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography as a prognostic biomarker in patients with locally advanced breast cancer

“…With respect to age, association between primary tumour SUVmax and age has been previously described with higher values of SUVmax in the primary tumour in patients younger than 45 years [25]. In our study, no significant relationships were observed between the patient's age and semiquantitative metabolic variables.…”

Correlation between 18F-FDG uptake on PET/CT and prognostic factors in triple-negative breast cancer

“…In this study, the SUV max data did not show a correlation with the axillary lymph node involvement status and p53 status. According to a recent study, the tumour SUV max on preoperative PET/CT correlated well with axillary lymph node metastasis for ER-positive/HER2-negative and HER2-positive tumours, but not for triple-negative tumours [34]. Prior breast cancer studies have demonstrated a correlation between 18 F-FDG uptake and p53 status [10,35], but there is also conflicting data in a study of 61 patients that failed to show a correlation [36].…”