Axillary Lymph Node-to-Primary Tumor Standard Uptake Value Ratio on Preoperative 18F-FDG PET/CT: A Prognostic Factor for Invasive Ductal Breast Cancer.
10.4048/jbc.2015.18.2.173
- Author:
Young Hwan KIM
1
;
Hai Jeon YOON
;
Yemi KIM
;
Bom Sahn KIM
Author Information
1. Department of Nuclear Medicine, Hanyang University Guri Hospital, Hanyang University School of Medicine, Guri, Korea.
- Publication Type:Original Article
- Keywords:
Breast neoplasms;
Fluorodeoxyglucose F18;
Lymph nodes;
Prognosis
- MeSH:
Breast Neoplasms*;
Electrons;
Estrogens;
Fluorodeoxyglucose F18*;
Follow-Up Studies;
Humans;
Lymph Nodes;
Multivariate Analysis;
Neoplasm Metastasis;
Positron-Emission Tomography and Computed Tomography*;
Prognosis;
Receptor, Epidermal Growth Factor;
Recurrence;
Ubiquitin-Protein Ligases
- From:Journal of Breast Cancer
2015;18(2):173-180
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study assessed the axillary lymph node (ALN)-to-primary tumor maximum standard uptake value (SUVmax) ratio (ALN/T SUV ratio) in invasive ductal breast cancer (IDC) on preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) to determine the effectiveness in predicting recurrence-free survival (RFS). METHODS: One hundred nineteen IDC patients (mean age, 50.5+/-10.5 years) with pathologically proven ALN involvement without distant metastasis and preoperative FDG PET/CT were enrolled in the study. SUVmax values of the ALN and primary tumor were obtained on FDG PET/CT, and ALN/T SUV ratio was calculated. Several factors were evaluated for their effectiveness in predicting RFS. These included several parameters on FDG PET/CT as well as several clinicopathological parameters: pathologic tumor/node stage; nuclear and histological grade; hormonal state; status with respect to human epidermal growth factor receptor 2, mindbomb E3 ubiquitin protein ligase 1 (MIB-1), and p53; primary tumor size; and ALN size. RESULTS: Among 119 patients with breast cancer, 17 patients (14.3%) experienced relapse during follow-up (mean follow-up, 28.4 months). The ALN/T SUV ratio of the group with disease recurrence was higher than that of the group without recurrence (0.97+/-1.60 and 0.45+/-0.40, respectively, p=0.005). Univariate analysis showed that the primary tumor SUVmax, ALN SUVmax, ALN/T SUV ratio, ALN status, nuclear and histological grade, estrogen receptor (ER) status, and MIB-1 status were predictors for RFS. Among these variables, ALN/T SUV ratio with hazard ratio of 4.20 (95% confidence interval [CI], 1.74-10.13) and ER status with hazard ratio of 4.33 (95% CI, 1.06-17.71) were predictors for RFS according to multivariate analysis (p=0.002 and p=0.042, respectively). CONCLUSION: Our study demonstrated that ALN/T SUV ratio together with ER status was an independent factor for predicting relapse in IDC with metastatic ALN. ALN/T SUV ratio on preoperative FDG PET/CT may be a useful marker for selecting IDC patients that need adjunct treatment to prevent recurrence.
