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FDG PET positive lymph nodes are highly predictive of metastasis in breast cancer.
Nucl Med Commun. 2006 Mar; 27(3):231-6.NM

Abstract

AIM

To determine whether or not fluorodeoxyglucose positron emission tomography (FDG PET) imaging when positive could obviate the necessity for sentinel lymph node biopsy and for complete axillary node dissection in patients with breast cancer.

METHODS

A total of 80 female patients with a histological diagnosis of breast cancer and clinically negative axillary nodes underwent an FDG PET and sentinel lymph node biopsy (SLNB) or total axillary dissection for staging of axilla. Both SLNB and axillary dissection were performed in 72 patients, while eight patients had total axillary dissection without SLN biopsy.

RESULTS

Of the 80 patients, 36 had lymph node metastasis on histopathology. SLNB was positive for metastasis in 35 (97%) of 36 patients (29 macrometastasis and seven micrometastasis). In the patient with false negative SLNB, the lymph node was completely replaced by the tumour. The FDG PET was true positive in 16 of 36 patients (sensitivity, 44%). There were two false positive studies with FDG PET, resulting in a specificity of 95%. The positive predictive value and accuracy of FDG PET for the detection of axillary lymph node metastasis were 89% and 72%, respectively. Univariate analysis revealed that higher grade of tumour, increased size and number of axillary lymph nodes were significantly associated with positive FDG PET results for axillary staging.

CONCLUSION

FDG PET cannot replace histological staging using SLNB in patients with breast cancer. However, FDG PET has a high specificity and positive predictive value for staging of the axilla in these patients. The patients with higher grade of tumour, larger size and higher number of axillary lymph nodes may be considered for FDG PET scan for axillary staging.

Authors+Show Affiliations

Division of Nuclear Medicine, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16479242

Citation

Kumar, Rakesh, et al. "FDG PET Positive Lymph Nodes Are Highly Predictive of Metastasis in Breast Cancer." Nuclear Medicine Communications, vol. 27, no. 3, 2006, pp. 231-6.
Kumar R, Zhuang H, Schnall M, et al. FDG PET positive lymph nodes are highly predictive of metastasis in breast cancer. Nucl Med Commun. 2006;27(3):231-6.
Kumar, R., Zhuang, H., Schnall, M., Conant, E., Damia, S., Weinstein, S., Chandra, P., Czerniecki, B., & Alavi, A. (2006). FDG PET positive lymph nodes are highly predictive of metastasis in breast cancer. Nuclear Medicine Communications, 27(3), 231-6.
Kumar R, et al. FDG PET Positive Lymph Nodes Are Highly Predictive of Metastasis in Breast Cancer. Nucl Med Commun. 2006;27(3):231-6. PubMed PMID: 16479242.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - FDG PET positive lymph nodes are highly predictive of metastasis in breast cancer. AU - Kumar,Rakesh, AU - Zhuang,Hongming, AU - Schnall,Mitchell, AU - Conant,Emily, AU - Damia,Stephanie, AU - Weinstein,Susan, AU - Chandra,Prem, AU - Czerniecki,Brain, AU - Alavi,Abass, PY - 2006/2/16/pubmed PY - 2006/5/23/medline PY - 2006/2/16/entrez SP - 231 EP - 6 JF - Nuclear medicine communications JO - Nucl Med Commun VL - 27 IS - 3 N2 - AIM: To determine whether or not fluorodeoxyglucose positron emission tomography (FDG PET) imaging when positive could obviate the necessity for sentinel lymph node biopsy and for complete axillary node dissection in patients with breast cancer. METHODS: A total of 80 female patients with a histological diagnosis of breast cancer and clinically negative axillary nodes underwent an FDG PET and sentinel lymph node biopsy (SLNB) or total axillary dissection for staging of axilla. Both SLNB and axillary dissection were performed in 72 patients, while eight patients had total axillary dissection without SLN biopsy. RESULTS: Of the 80 patients, 36 had lymph node metastasis on histopathology. SLNB was positive for metastasis in 35 (97%) of 36 patients (29 macrometastasis and seven micrometastasis). In the patient with false negative SLNB, the lymph node was completely replaced by the tumour. The FDG PET was true positive in 16 of 36 patients (sensitivity, 44%). There were two false positive studies with FDG PET, resulting in a specificity of 95%. The positive predictive value and accuracy of FDG PET for the detection of axillary lymph node metastasis were 89% and 72%, respectively. Univariate analysis revealed that higher grade of tumour, increased size and number of axillary lymph nodes were significantly associated with positive FDG PET results for axillary staging. CONCLUSION: FDG PET cannot replace histological staging using SLNB in patients with breast cancer. However, FDG PET has a high specificity and positive predictive value for staging of the axilla in these patients. The patients with higher grade of tumour, larger size and higher number of axillary lymph nodes may be considered for FDG PET scan for axillary staging. SN - 0143-3636 UR - https://www.unboundmedicine.com/medline/citation/16479242/FDG_PET_positive_lymph_nodes_are_highly_predictive_of_metastasis_in_breast_cancer_ L2 - https://doi.org/10.1097/00006231-200603000-00005 DB - PRIME DP - Unbound Medicine ER -