The Role of 18F-FDG-PET/CT in the Management of Patients with High-Risk Breast Cancer: Case Series and Guideline Comparison


Objectives: In grade III-IV breast cancer, dissemination of disease needs to be assessed. Until now this was done by conventional imaging (liver ultrasonography, chest X-ray and bone scintigraphy), but evidence favoring the use of FDG-PET/CT is accumulating. Methods: Patients with high-risk breast cancer, who had received conventional imaging and FDG-PET/CT, were included. Patients were staged and assigned a treatment after 1) conventional imaging and 2) FDG-PET/CT, both by a multidisciplinary oncology team. Equivocal FDG-PET/CT findings were histologically confirmed. Results: 16 patients were included (mean age 59 years). TNM-stage changed in 5 patients (31%) after FDG-PET/CT. In 3 patients (19%) unknown distant metastases were detected by FDG-PET/CT. An adjustment of treatment took place in 4 patients (25%). Conclusions: Our case series emphasizes the role of FDG-PET/CT in the staging of high-risk breast carcinoma, especially in the assessment of distant metastases. We suggest replacing conventional imaging with FDG-PET/CT.

Share and Cite:

F. Bulten, B. , J. de Haas, M. , J. Bloemendal, H. , J. van Overbeeke, A. , Paul Esser, J. , J. Baarslag, H. , de Geus-Oei, L. , J. Rodenburg, C. and M. H. de Klerk, J. (2014) The Role of 18F-FDG-PET/CT in the Management of Patients with High-Risk Breast Cancer: Case Series and Guideline Comparison. Advances in Molecular Imaging, 4, 35-41. doi: 10.4236/ami.2014.43005.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Ferlay, J., Steliarova-Foucher, E., Lortet-Tieulent, J., Rosso, S., Coebergh, J.W., Comber, H., et al. (2013) Cancer Incidence and Mortality Patterns in Europe: Estimates for 40 Countries in 2012. European Journal of Cancer, 49, 1374-1403.
[2] Aukema, T.S., Rutgers, E.J., Vogel, W.V., Teertstra, H.J., Oldenburg, H.S., Vrancken Peeters, M.T., et al. (2010) The Role of FDG PET/CT in Patients with Locoregional Breast Cancer Recurrence: A Comparison to Conventional Imaging Techniques. European Journal of Surgical Oncology, 36, 387-392.
[3] Fuster, D., Duch, J., Paredes, P., Velasco, M., Munoz, M., Santamaria, G., et al. (2008) Preoperative Staging of Large Primary Breast Cancer with [18F]fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Compared with Conventional Imaging Procedures. Journal of Clinical Oncology, 26, 4746-4751.
[4] Mahner, S., Schirrmacher, S., Brenner, W., Jenicke, L., Habermann, C.R., Avril, N., et al. (2008) Comparison between Positron Emission Tomography Using 2-[Fluorine-18]fluoro-2-deoxy-D-glucose, Conventional Imaging and Computed Tomography for Staging of Breast Cancer. Annals of Oncology, 19, 1249-1254.
[5] National Breast Cancer Consultation Group (2012) National Guideline Breast Cancer.
[6] Puglisi, F., Follador, A., Minisini, A.M., Cardellino, G.G., Russo, S., Andreetta, C., et al. (2005) Baseline Staging Tests after a New Diagnosis of Breast Cancer: Further Evidence of Their Limited Indications. Annals of Oncology, 16, 263-266.
[7] van der Hoeven, J.J., Krak, N.C., Hoekstra, O.S., Comans, E.F., Boom, R.P., van Geldere, D., et al. (2004) 18F-2-fluoro-2-deoxy-d-glucose Positron Emission Tomography in Staging of Locally Advanced Breast Cancer. Journal of Clinical Oncology, 22, 1253-1259.
[8] Koolen, B.B., Vrancken Peeters, M.J., Aukema, T.S., Vogel, W.V., Oldenburg, H.S., van der Hage, J.A., et al. (2012) 18F-FDG PET/CT as a Staging Procedure in Primary Stage II and III Breast Cancer: Comparison with Conventional Imaging Techniques. Breast Cancer Research and Treatment, 131, 117-126.
[9] Pennant, M., Takwoingi, Y., Pennant, L., Davenport, C., Fry-Smith, A., Eisinga, A., et al. (2010) A Systematic Review of Positron Emission Tomography (PET) and Positron Emission Tomography/Computed Tomography (PET/CT) for the Diagnosis of Breast Cancer Recurrence. Health Technology Assessment, 14, 1-103.
[10] Cancer, N.C.C.F. (2009) Advanced Breast Cancer: Diagnosis and Treatment.
[11] Fanggiday, J.C., Staaks, G.H.A., de Haas, M.J., Schaefer-Prokop, C.M. and de Klerk, J.M.H. (2011) Discordancy in CT and PET in Detection and Follow Up of Bone Metastases in a Patient with Small Cell Lung Cancer. Dutch Journal of Nuclear Medicine, 33, 558-560.
[12] Senkus, E., Kyriakides, S., Penault-Llorca, F., Poortmans, P., Thompson, A., Zackrisson, S., et al. (2013) Primary Breast Cancer: ESMO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up. Annals of Oncology, 24, vi7-vi23.
[13] Carlson, R.W., Allred, D.C., Anderson, B.O., Burstein, H.J., Carter, W.B., Edge, S.B., et al. (2009) Breast Cancer. Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network, 7, 122-192.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.