Abstract
Background
18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) has been widely used for diagnosis and staging of disease recurrence in breast cancer patients.
Purpose
To determine the validity of 18F-FDG PET/CT maximum standardized uptake value (SUVmax) of primary breast cancer (SUVmax-T) as a prognostic factor for locoregional axillary lymph node metastasis (ALNM).
Material and Methods
We prospectively studied 198 female patients with pathologically proven breast cancer. All patients were submitted to 18F-FDG PET/CT imaging for their initial tumor staging. The SUVmax-T on 18F-FDG PET/CT and ALNM were assessed. The patients were categorized into two groups; group A, with ALNM, and group B, without ALNM, according to the presence of locoregional ALNM on visual analysis of 18F-FDG PET/CT. The correlations and differences between two groups were statistically evaluated. The optimal cut-off value of SUVmax-T was determined.
Results
The mean tumor size in group A was significantly greater than that in group B (P = 0.0416). The mean SUVmax-T value in group A was significantly higher than that in group B (P = 0.0037). Tumor stage in group A was higher than that in group B (P = 0.0045). The correlation between tumor size and SUVmax-T value was statistically significant in group A (r = 0.6768, P = 0.0111) and in group B (r = 0.7221, P = 0.0280). The optimal cut-off of SUVmax-T for detecting ALNM was >4.2. As regards molecular subtypes, the mean SUVmax-T values of HER2-positive and triple-negative subtypes in group A were significantly higher than that in group B (P = 0.0012 and <0.001, respectively).
Conclusion
Breast cancer patients with higher primary tumor 18F-FDG uptake are at greater risk of concurrent ALNM.
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