Abstract：
OBJECTIVE: While 18F-FDG PET/CT (FDG-PET/CT) is consensual for clinical stage ≥ IIB breast cancers (BC), its benefit for stage I or IIA HER2+ or triple-negative breast cancer (TNBC) patients lacks sufficient evidence. We reported a single-institution, retrospective study evaluating FDG-PET/CT impact on patient management and staging for stage I or IIA HER2+ or Triple-Negative BC.
METHODS: Patients who underwent FDG-PET/CT staging before any treatment between January 2015 and December 2020 at Oscar Lambret Center were included.
METHODS: patients with symptoms or conventional imaging suggestive of metastatic dissemination, or with prior malignancies. Initial stage was determined from mammography, breast ultrasound, breast MRI, and clinical examination. Staging and therapeutic impact based on FDG-PET/CT findings collected, including intra- (modification of dose/site/strategy in a type of management previously indicated) and inter-modality (modification of planned treatment strategy) changes.
RESULTS: The cohort included 287 female patients with clinical stage I or IIA, HER2+ , or TNBC. Therapeutic impact observed for 18% of patients (n = 52), with 2% (n = 7) undergoing inter-modality change with omission of planned surgery. The impact on patient management was higher for stage IIA patients (20%, 47/237) than for stage I patients (10%, 5/50). Among stage IIA disease, changes in management were more important for T2N0 patients (22%, 44/205) than for T1N1 patients (9%, 3/32). While not statistically significant, trends suggest usefulness of FDG-PET/CT for T2N0 patients.
CONCLUSIONS: Considering substantial therapeutic implications, our study suggests the usefulness of FDG-PET/CT for patients with stage IIA, HER2-positive, or Triple-Negative BC with tumor size > 2 cm (T2N0).
METHODS: Patients who underwent FDG-PET/CT staging before any treatment between January 2015 and December 2020 at Oscar Lambret Center were included.
METHODS: patients with symptoms or conventional imaging suggestive of metastatic dissemination, or with prior malignancies. Initial stage was determined from mammography, breast ultrasound, breast MRI, and clinical examination. Staging and therapeutic impact based on FDG-PET/CT findings collected, including intra- (modification of dose/site/strategy in a type of management previously indicated) and inter-modality (modification of planned treatment strategy) changes.
RESULTS: The cohort included 287 female patients with clinical stage I or IIA, HER2+ , or TNBC. Therapeutic impact observed for 18% of patients (n = 52), with 2% (n = 7) undergoing inter-modality change with omission of planned surgery. The impact on patient management was higher for stage IIA patients (20%, 47/237) than for stage I patients (10%, 5/50). Among stage IIA disease, changes in management were more important for T2N0 patients (22%, 44/205) than for T1N1 patients (9%, 3/32). While not statistically significant, trends suggest usefulness of FDG-PET/CT for T2N0 patients.
CONCLUSIONS: Considering substantial therapeutic implications, our study suggests the usefulness of FDG-PET/CT for patients with stage IIA, HER2-positive, or Triple-Negative BC with tumor size > 2 cm (T2N0).
摘要：
目的：虽然18F-FDGPET/CT（FDG-PET/CT）是临床分期≥IIB乳腺癌（BC）的共识，其对I期或IIA期HER2+或三阴性乳腺癌(TNBC)患者的益处缺乏足够的证据.我们报告了一个单一的机构，回顾性研究评估FDG-PET/CT对I期或IIA期HER2+或三阴性BC患者管理和分期的影响。
方法：纳入2015年1月至2020年12月在OscarLambret中心进行任何治疗之前接受FDG-PET/CT分期的患者。
方法：有症状或常规影像学提示转移播散的患者，或先前的恶性肿瘤。从乳房X线照相术确定初始阶段，乳腺超声,乳腺MRI,和临床检查。根据收集的FDG-PET/CT结果进行分期和治疗效果，包括内部（在先前指示的一种管理中修改剂量/部位/策略）和模式间（修改计划治疗策略）的变化。
结果：该队列包括287名临床I期或IIA期女性患者，HER2+,或TNBC。18％的患者（n=52）观察到治疗效果，2%(n=7)的患者在省略计划手术的情况下进行模态间改变。IIA期患者对患者管理的影响更高(20%，47/237）比I期患者（10%，5/50）。在IIA期疾病中，管理的改变对T2N0患者更为重要(22%，44/205）比T1N1患者（9%，3/32).虽然没有统计学意义，趋势提示FDG-PET/CT对T2N0患者有用。
结论：考虑到实质性的治疗意义，我们的研究表明FDG-PET/CT对IIA期患者的有用性，HER2阳性,或三阴性BC，肿瘤大小>2cm（T2N0）。
方法：纳入2015年1月至2020年12月在OscarLambret中心进行任何治疗之前接受FDG-PET/CT分期的患者。
方法：有症状或常规影像学提示转移播散的患者，或先前的恶性肿瘤。从乳房X线照相术确定初始阶段，乳腺超声,乳腺MRI,和临床检查。根据收集的FDG-PET/CT结果进行分期和治疗效果，包括内部（在先前指示的一种管理中修改剂量/部位/策略）和模式间（修改计划治疗策略）的变化。
结果：该队列包括287名临床I期或IIA期女性患者，HER2+,或TNBC。18％的患者（n=52）观察到治疗效果，2%(n=7)的患者在省略计划手术的情况下进行模态间改变。IIA期患者对患者管理的影响更高(20%，47/237）比I期患者（10%，5/50）。在IIA期疾病中，管理的改变对T2N0患者更为重要(22%，44/205）比T1N1患者（9%，3/32).虽然没有统计学意义，趋势提示FDG-PET/CT对T2N0患者有用。
结论：考虑到实质性的治疗意义，我们的研究表明FDG-PET/CT对IIA期患者的有用性，HER2阳性,或三阴性BC，肿瘤大小>2cm（T2N0）。
