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18F-FDG PET/CT More Accurate in Staging Breast Cancer

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Lesions in patients with locally advanced breast cancer can be better detected with 18F-FDG PET/CT to allow for changes in treatment management.

Chest, abdomen, and bone lesions in patients with locally advanced breast cancer can be detected in a single session with 18F-fludeoxyglucose (18F-FDG) positron emission tomography PET/computed tomography scans. These images then allow physicians to change management approaches early in treatment if needed, according to a study in the January issue of The Journal of Nuclear Medicine.

Researchers assessed 117 patients who had locally advanced breast cancer (35 inflammatory, 82 non-inflammatory) over a 60-month period. The patients underwent the 18F-FDG PET/CT and the results were compared with previously conducted conventional staging approaches that included bone scans, chest X–rays, or dedicated CT and abdominopelvic sonography or contrast-enhanced CT.

"The prognosis of patients with locally advanced breast cancer remains poor. In this study we aimed to investigate whether the use of 18F-FDG PET/CT at initial staging could have an impact on the prognostic stratification and management of patients with locally advanced breast cancer," said David Groheux, MD, PhD, lead author of the study.

The findings showed that all primary tumors were identified by 18F-FDG PET/CT. The scans confirmed lymph node involvement in stage IIIC patients and revealed unsuspected lymph node involvement in 32 additional patients. Furthermore, distant metastases (bone, distant lymph nodes, liver, lung and pleura) were visualized with 18F-FDG PET/CT in 43 patients; conventional imaging only identified 28 patients with distant metastases. Overall, 18F-FDG PET/CT changed the stage of 61 out of 117 patients, which, in turn, impacted the recommended treatment for the patients.

This type of scanning can lead to a personalized medical approach, Groheux said in a press release. "Based on these findings, 18F-FDG PET/CT may become the single most important distant staging modality in patients with locally advanced breast cancer."

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