İstanbul Medical Journal (Jan 2020)
The Value of F-18-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography for the Detection of Residual Breast Tumor or Axillary Metastasis after Neoadjuvant Chemotherapy in Invasive Ductal Carcinoma of the Breast
Abstract
Introduction:Accurate evaluation of pathological response after neoadjuvant chemotherapy would aid in treatment and surgical planning as well as prediction of outcomes. This study examined the value of F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) in predicting pathologically confirmed residual tumor in breast or presence of axillary metastasis when performed after completion of neoadjuvant therapy in patients with invasive ductal carcinoma (IDC) of the breast cancer.Methods:This retrospective study included 52 IDC of the breast who received neoadjuvant chemotherapy and underwent F-18-FDG PET/CT between 2015 and 2019 after completion of neoadjuvant chemotherapy. Diagnostic performance parameters of F-18-FDG PET/CT for predicting residual tumor or presence of axillary metastasis were estimated based on histopathological findings.Results:All patients had IDC. F-18-FDG PET/CT exhibited high specificity for both locations (89.5% and 93.8% and for breast and axilla, respectively). The sensitivity of the method, on the other hand, was low for both locations (66.7% and 30.0% for breast and axilla, respectively), particularly for axilla. False-negative rate (i.e., missing rate) for breast and axilla was 9.1% and 0% for the tumors >8 mm in diameter.Conclusion:F-18-FDG PET/CT does not seem to provide reliable information on the presence of a residual tumor or node metastasis when performed after the completion of neoadjuvant treatment in IDC of the breast. New diagnostic modalities utilized at different time points or including a combination of different imaging methods are warranted.
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