Breast cancer recurrence diagnosis suspected on tumor marker rising
- 8 November 2010
- Vol. 117 (8), 1621-1629
- https://doi.org/10.1002/cncr.25727
Abstract
BACKGROUND: Breast cancer recurrence is often suspected on tumor marker rising in asymptomatic patients. The value of fluorine‐18 fluorodeoxyglucose (18FDG)–positron emission tomography/computed tomography (PET/CT) imaging to detect recurrence and its subsequent impact on patient management were retrospectively assessed. METHODS: PET/CT scans were performed on 228 asymptomatic patients (mean, 60.8 years; range, 30‐91 years) presenting with rising CA 15‐3 and/or CEA serum levels. RESULTS: PET/CT scans were positive in 181 patients (79.5%) and normal in 47 patients, whereas 187 true recurrences were diagnosed. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/CT imaging for detection of breast cancer recurrence were 93.6%, 85.4%, 96.7%, 74.5%, and 92.1%, respectively. When compared with the standard workup available in 67 patients, PET/CT imaging had a higher sensitivity and accuracy (94.5% vs 33% and 94% vs 48%, respectively). Recurrences were confirmed by pathology, conventional imaging techniques, or radiological and clinical follow‐up beyond 1 year (mean, 34 months; range, 12‐67 years) in 32, 130, and 25 patients, respectively. The diagnosis of recurrence led to a treatment modification in 123 patients (54%). CONCLUSIONS: 18FDG‐PET/CT imaging is an efficient technique to detect breast cancer recurrence suspected on tumor marker rising in asymptomatic patients. It may thus contribute to improve patient management, providing an earlier diagnosis with complete whole‐body staging as a “one‐stop shop” procedure. Cancer 2011. © 2010 American Cancer Society.Keywords
This publication has 34 references indexed in Scilit:
- The role of FDG PET/CT in patients with locoregional breast cancer recurrence: A comparison to conventional imaging techniquesEuropean Journal of Surgical Oncology, 2010
- Triple-negative breast cancer—current status and future directionsAnnals Of Oncology, 2009
- Meta-analysis: Comparison of F-18 Fluorodeoxyglucose-Positron Emission Tomography and Bone Scintigraphy in the Detection of Bone Metastases in Patients With Breast CancerClinical Nuclear Medicine, 2008
- American Society of Clinical Oncology 2007 Update of Recommendations for the Use of Tumor Markers in Breast CancerJournal of Clinical Oncology, 2007
- F-18-Fluoro-2-Deoxyglucose Positron Emission Tomography/Computed Tomography in the Follow-up of Breast Cancer With Elevated Levels of Tumor MarkersJournal of Computer Assisted Tomography, 2007
- FDG-PET/CT in restaging of patients with recurrent breast cancer: possible impact on staging and therapyThe British Journal of Radiology, 2007
- Primary breast cancer: ESMO Clinical Recommendations for diagnosis, treatment and follow-upAnnals of Oncology, 2007
- Influence of CA 15-3 blood level and doubling time on diagnostic performances of 18F-FDG PET in breast cancer patients with occult recurrenceNuclear Medicine Communications, 2007
- The role of FDG‐PET/CT in suspected recurrence of breast cancerCancer, 2006
- A meta-analysis of FDG-PET for the evaluation of breast cancer recurrence and metastasesBreast Cancer Research and Treatment, 2005