%0 Journal Article
%T FDG-PET/CT in high-risk primary breast cancer-a prospective study of stage migration and clinical impact.
%A Vogsen M
%A Jensen JD
%A Christensen IY
%A Gerke O
%A Jylling AMB
%A Larsen LB
%A Braad PE
%A Søe KL
%A Bille C
%A Ewertz M
%A Hildebrandt MG
%J Breast Cancer Res Treat
%V 185
%N 1
%D Jan 2021
%M 32920740
%F 4.624
%R 10.1007/s10549-020-05929-3
%X OBJECTIVE: To investigate the clinical impact of FDG-PET/CT for staging and treatment planning in high-risk primary breast cancer.
METHODS: Women with high-risk primary breast cancer were enrolled between September 2017 and August 2019 at Odense University Hospital, Denmark. Conventional mammography with/without MRI was performed before staging by FDG-PET/CT. We studied the accuracy of FDG-PET/CT for the detection of distant metastases, the effect on the change of treatment, and the prevalence of incidental findings. Biopsy and follow-up were used as a reference standard for the accuracy analysis.
RESULTS: Of 103 women, 24 (23%) were diagnosed with distant metastases by FDG-PET/CT. Among these, breast surgery was omitted in 18 and could have been spared in six. Another sixteen (16%) patients were upstaged to more advanced loco-regional disease, leading to more extensive radiotherapy. Sensitivity and specificity for diagnosing distant metastases were 1.00 (95% confidence interval: 0.86-1.00) and 0.95 (0.88-0.99), respectively. Twenty-nine incidental findings were detected in 24 women (23%), leading to further examinations in 22 and diagnosis of eight (8/22, 36%) synchronous diseases: cancer (n = 4), thyroiditis (n = 2), aorta aneurysm (n = 1), and meningioma (n = 1).
CONCLUSIONS: FDG-PET/CT had a substantial impact on staging and change of treatment in women with high-risk primary breast cancer, and further examination of incidental findings was considered clinically relevant. Our findings suggest that FDG-PET/CT should be considered for primary staging in high-risk primary breast cancer to improve treatment planning.