Correlation between Histopathological Prognostic Tumor Characteristics and [<sup>18</sup>F]FDG Uptake in Corresponding Metastases in Newly Diagnosed Metastatic Breast Cancer
Jorianne Boers,
Bertha Eisses,
Mieke C. Zwager,
Jasper J. L. van Geel,
Frederike Bensch,
Erik F. J. de Vries,
Geke A. P. Hospers,
Andor W. J. M. Glaudemans,
Adrienne H. Brouwers,
Martijn A. M. den Dekker,
Sjoerd G. Elias,
Evelien J. M. Kuip,
Carla M. L. van Herpen,
Agnes Jager,
Astrid A. M. van der Veldt,
Daniela E. Oprea-Lager,
Elisabeth G. E. de Vries,
Bert van der Vegt,
Willemien C. Menke-van der Houven van Oordt,
Carolina P. Schröder
Affiliations
Jorianne Boers
Department of Medical Oncology, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
Bertha Eisses
Department of Medical Oncology, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
Mieke C. Zwager
Department of Pathology, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
Jasper J. L. van Geel
Department of Medical Oncology, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
Frederike Bensch
Department of Medical Oncology, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
Erik F. J. de Vries
Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
Geke A. P. Hospers
Department of Medical Oncology, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
Andor W. J. M. Glaudemans
Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
Adrienne H. Brouwers
Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
Martijn A. M. den Dekker
Department of Radiology, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
Sjoerd G. Elias
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3584 Utrecht, The Netherlands
Evelien J. M. Kuip
Department of Medical Oncology, Radboud Medical Center, 6500 Nijmegen, The Netherlands
Carla M. L. van Herpen
Department of Medical Oncology, Radboud Medical Center, 6500 Nijmegen, The Netherlands
Agnes Jager
Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 Rotterdam, The Netherlands
Astrid A. M. van der Veldt
Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 Rotterdam, The Netherlands
Daniela E. Oprea-Lager
Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Location VU University Medical Center, 1081 Amsterdam, The Netherlands
Elisabeth G. E. de Vries
Department of Medical Oncology, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
Bert van der Vegt
Department of Pathology, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
Willemien C. Menke-van der Houven van Oordt
Department of Medical Oncology, Amsterdam University Medical Center, Location VU University Medical Center, 1081 Amsterdam, The Netherlands
Carolina P. Schröder
Department of Medical Oncology, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
Background: In metastatic breast cancer (MBC), [18F]fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG-PET/CT) can be used for staging. We evaluated the correlation between BC histopathological characteristics and [18F]FDG uptake in corresponding metastases. Patients and Methods: Patients with non-rapidly progressive MBC of all subtypes prospectively underwent a baseline histological metastasis biopsy and [18F]FDG-PET. Biopsies were assessed for estrogen, progesterone, and human epidermal growth factor receptor 2 (ER, PR, HER2); Ki-67; and histological subtype. [18F]FDG uptake was expressed as maximum standardized uptake value (SUVmax) and results were expressed as geometric means. Results: Of 200 patients, 188 had evaluable metastasis biopsies, and 182 of these contained tumor. HER2 positivity and Ki-67 ≥ 20% were correlated with higher [18F]FDG uptake (estimated geometric mean SUVmax 10.0 and 8.8, respectively; p = 0.0064 and p = 0.014). [18F]FDG uptake was lowest in ER-positive/HER2-negative BC and highest in HER2-positive BC (geometric mean SUVmax 6.8 and 10.0, respectively; p = 0.0058). Although [18F]FDG uptake was lower in invasive lobular carcinoma (n = 31) than invasive carcinoma NST (n = 146) (estimated geometric mean SUVmax 5.8 versus 7.8; p = 0.014), the metastasis detection rate was similar. Conclusions: [18F]FDG-PET is a powerful tool to detect metastases, including invasive lobular carcinoma. Although BC histopathological characteristics are related to [18F]FDG uptake, [18F]FDG-PET and biopsy remain complementary in MBC staging (NCT01957332).
