Value of F-18 FDG PET/CT in detection and prognostication of isolated extra-axillary lymph node recurrences in postoperative breast cancer
Issue title: Frontiers in Biomedical Engineering and Biotechnology – Proceedings of the 2nd International Conference on Biomedical Engineering and Biotechnology, 11–13 October 2013, Wuhan, China
Affiliations: Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea | Department of Radiation oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea | Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea | Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea | Department of Radiology, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
Abstract: We assessed the role of F-18 FDG PET/CT in evaluating isolated extra-axillary lymph node recurrences in postoperative breast cancer patients and its prognostic value on clinical outcome. We reviewed PET/CT scans of postoperative breast cancer patients performed at our institution between July 2003 and February 2012. We recorded PET/CT findings, clinicopathologic variables and treatment modalities. We analyzed metabolic parameters from PET/CT and clinicopathologic variables with respect to progression free survival (PFS). A total of 3561 PET/CT scans were performed in 1906 postoperative breast cancer patients with a median interval of 43 month from curative surgery. Fifty seven patients (2.99%) demonstrated isolated extra-axillary nodal recurrences (n=85) on PET/CT (internal mammary node recurrences in 28, supraclavicular 24, infraclavicular 4, interpectoral 8, cervical 12, and mediastinal 9).The median SUVmax was 7.8 (range, 1.8~19.0), and the median node size was 15 mm (range, 6~38 mm). All recurrences were nonpalpable. Based on PET/CT findings, 53 out of 57 patients with extra-axillary node recurrences underwent subsequent chemotherapy/radiation therapy. The estimated 3-year PFS rate was 48.6%. Cutoff points of SUVmax 2.7 and size 14 mm were the best discriminative values for predicting clinical outcome. SUVmax and size of extra-axillary nodal recurrences were significantly correlated to PFS on univariate and multivariate analyses (p<0.001 and p=0.019, respectively).
Keywords: Breast cancer, extra-axillary lymph node, recurrence, PET/CT, prognosis
