FDG-PET/CT in high-risk primary breast cancer—a prospective study of stage migration and clinical impact

Marianne Vogsen, Jeanette Dupont Jensen, Ivar Yannick Christensen, Oke Gerke, Anne Marie Bak Jylling, Lisbet Brønsro Larsen, Poul-Erik Braad, Katrine Lydolph Søe, Camilla Bille, Marianne Ewertz, Malene Hildebrandt

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Purpose To investigate the clinical impact of FDG-PET/CT for staging and treatment planning in high-risk primary breast cancer.
Methods Women with high-risk primary breast cancer were enrolled between September 2017 and August 2019 at Odense University Hospital, Denmark. Conventional mammography with/without MRI was performed before staging by FDG-PET/CT. We studied the accuracy of FDG-PET/CT for the detection of distant metastases, the effect on the change of treatment, and the prevalence of incidental findings. Biopsy and follow-up were used as a reference standard for the accuracy analysis.
Results Of 103 women, 24 (23%) were diagnosed with distant metastases by FDG-PET/CT. Among these, breast surgery was omitted in 18 and could have been spared in six. Another sixteen (16%) patients were upstaged to more advanced loco-regional disease, leading to more extensive radiotherapy. Sensitivity and specificity for diagnosing distant metastases were 1.00 (95% confidence interval: 0.86-1.00) and 0.95 (0.88-0.99), respectively. Twenty-nine incidental findings were detected in 24 women (23%), leading to further examinations in 22 and diagnosis of eight (8/22, 36%) synchronous diseases: cancer (n=4), thyroiditis (n=2), aorta aneurysm (n=1), and meningioma (n=1).
Conclusions FDG-PET/CT had a substantial impact on staging and change of treatment in women with high-risk primary breast cancer, and further examination of incidental findings was considered clinically relevant. Our findings suggest that FDG-PET/CT should be considered for primary staging in high-risk primary breast cancer to improve treatment planning.
Original languageEnglish
Publication date17. Sep 2020
Publication statusPublished - 17. Sep 2020
EventESMO 2020 - Virtuelt
Duration: 17. Sep 202021. Sep 2020


ConferenceESMO 2020

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