PURPOSE: PET/CT is useful in preoperative evaluation of invasive breast cancer (IBC) to predict axillary metastasis and staging workup. The usefulness is unclear in cases of ductal carcinoma in situ (DCIS) diagnosed at biopsy before surgery, which sometimes is upgraded to IBC after definitive surgery. The aim of this study is to find out the usefulness of PET/CT on DCIS as a preoperative evaluation tool. METHODS: We investigated 102 patients preoperatively diagnosed with DCIS who subsequently underwent definitive surgery between 2010 and 2015. The uptake of 18F-fluorodeoxyglucose was graded by visual and semiquantitative methods. We analyzed the maximum standardized uptake value (SUVmax) of each patient with clinicopathologic variables. We determined optimal cutoff values for SUVmax by receiver operating characteristic curve analysis. RESULTS: Fifteen cases out of 102 cases (14.7%) were upgraded to IBC after surgery. The SUVmax was higher in patients upgraded to IBC (mean: 2.56 vs. 1.36) (P = 0.007). The SUVmax was significantly higher in patients who had symptoms, palpable masses, lesions over 2 cm in size and BI-RAD category 5. Both visual and semiquantitative analysis were significant predictors of IBC underestimation. SUVmax of 2.65 was the theoretical cutoff value in ROC curve analysis in predicting the underestimation of IBC. The underestimation rate was significantly higher in patients with SUVmax >2.65 (P < 0.001), over the moderate enhanced uptake on visual analysis (P < 0.001). CONCLUSION: PET/CT can be used as a complementary evaluation tool to predict the underestimation of DCIS combined with the lesion size, palpable mass, symptomatic lesion, and BI-RAD category.
Biopsy ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography ; ROC Curve

PURPOSE: Papillary carcinoma of the breast is a rare disease and accounts for 1-2% of all breast cancers. Because of its rarity, there have been no reports regarding prognostic factors of papillary carcinoma of the breast. The aim of this study was to review the clinicopathological factors and treatment modalities of papillary carcinoma of the breast and to evaluate the relationship between these factors and survival rates. METHODS: We retrospectively analyzed 31 patients diagnosed with papillary carcinoma of the breast from January 1986 to December 2005. RESULTS: The mean age of the patients was 53.5 yr. The most common symptom was a palpable mass (n=27). The mean size of a tumor was 3.5 cm and 41.9% of the patients were categorized as T2. Eighteen patients had node negative breast cancer. According to the TNM stage, there were 5, 5, 16 and 2 patients with stage 0, I, II and III disease, respectively. Expression of estrogen receptor and progesterone receptor were positive in 80.8% and 69.2% of the patients, respectively. Twenty-three patients underwent mastectomy and eight patients underwent breast-conserving surgery. Fourteen patients received chemotherapy, 20 patients received hormone therapy, and 10 patients received radiotherapy. The 10-yr disease-free survival rate and 10-yr overall survival rate were 74.9% and 86.1%, respectively. Axillary lymph node negative and an age under 50 yr were statistically significant factors in 5-yr disease-free survival and in 5-yr overall survival, respectively. CONCLUSION: Papillary carcinoma of the breast showed a favorable outcome. Lymph node status and age were statistically significant factors for survival rates. The tumor size and stage had a relation with the survival rate, although the relation was not statistically significant.
Breast ; Breast Neoplasms ; Carcinoma, Papillary ; Disease-Free Survival ; Estrogens ; Humans ; Lymph Nodes ; Mastectomy ; Mastectomy, Segmental ; Prognosis ; Rare Diseases ; Receptors, Progesterone ; Retrospective Studies ; Survival Rate