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18 F-FDG-PET/CT in breast cancer imaging : Restaging and Implications for treatment decisions in a clinical practice setting

Skarping, Ida LU orcid (2024) In Acta Oncologica 63. p.669-677
Abstract

Background and purpose: Although the diagnostic accuracy of 18F-fluorodeoxyglucose – positron emission tomography/computed tomography (18F-FDG-PET/CT) for breast cancer (BC) has been well studied, few studies have evaluated the impact of 18F-FDG-PET/CT on BC patient care. This study aimed to investigate restaging and 18F-FDG-PET/CT-induced changes in clinical decision-making in patients with BC. Material and methods: We retrospectively evaluated 18F-FDG-PET/CT-scans performed for BC-related indications in a prospectively collected consecutive cohort of adult patients at Skane University Hospital, Sweden. Patients with all BC stages were included and divided into three groups based... (More)

Background and purpose: Although the diagnostic accuracy of 18F-fluorodeoxyglucose – positron emission tomography/computed tomography (18F-FDG-PET/CT) for breast cancer (BC) has been well studied, few studies have evaluated the impact of 18F-FDG-PET/CT on BC patient care. This study aimed to investigate restaging and 18F-FDG-PET/CT-induced changes in clinical decision-making in patients with BC. Material and methods: We retrospectively evaluated 18F-FDG-PET/CT-scans performed for BC-related indications in a prospectively collected consecutive cohort of adult patients at Skane University Hospital, Sweden. Patients with all BC stages were included and divided into three groups based on the indication for18F-FDG-PET/CT: Group A (primary staging), Group B (response evaluation), and Group C (recurrence). The impact of 18F-FDG-PET/CT-scans on clinical management was categorized as no change, minor change (e.g. modification of treatment plans), or major change (e.g. shift from curative to palliative treatment intention). Results: A total of 376 scans (151 patients) were included: Group A 9.3% (35 of 376 scans), Group B 77.4% (291 of 376 scans), and Group C 13.3% (50 of 376 scans). Significant stage migration, predominantly upstag-ing, occurred in Group A (45.7%) and Group C (28.0%). Changes in clinical management were observed in 120 scans (31.9%), of which 66 were major and 54 were minor. The largest proportion of18F-FDG-PET/ CT-induced management changes were observed in Group A (57.1%), most commonly a shift from curative to palliative treatment intention due to upstaging. Interpretation: Our study indicates the clinical utility of 18F-FDG-PET/CT in BC restaging and changes in clinical management; the latter observed in approximately one-third of all cases.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
F-FDG, Breast cancer, clinical management, imaging, PET/CT, staging
in
Acta Oncologica
volume
63
pages
9 pages
publisher
Taylor & Francis
external identifiers
  • pmid:39129250
  • scopus:85201244806
ISSN
0284-186X
DOI
10.2340/1651-226X.2024.40003
language
English
LU publication?
yes
id
615ee5ee-991e-4804-8c69-7137c99238d9
date added to LUP
2025-01-16 12:02:02
date last changed
2025-07-04 02:22:02
@article{615ee5ee-991e-4804-8c69-7137c99238d9,
  abstract     = {{<p>Background and purpose: Although the diagnostic accuracy of <sup>18</sup>F-fluorodeoxyglucose – positron emission tomography/computed tomography (<sup>18</sup>F-FDG-PET/CT) for breast cancer (BC) has been well studied, few studies have evaluated the impact of <sup>18</sup>F-FDG-PET/CT on BC patient care. This study aimed to investigate restaging and <sup>18</sup>F-FDG-PET/CT-induced changes in clinical decision-making in patients with BC. Material and methods: We retrospectively evaluated <sup>18</sup>F-FDG-PET/CT-scans performed for BC-related indications in a prospectively collected consecutive cohort of adult patients at Skane University Hospital, Sweden. Patients with all BC stages were included and divided into three groups based on the indication for<sup>18</sup>F-FDG-PET/CT: Group A (primary staging), Group B (response evaluation), and Group C (recurrence). The impact of <sup>18</sup>F-FDG-PET/CT-scans on clinical management was categorized as no change, minor change (e.g. modification of treatment plans), or major change (e.g. shift from curative to palliative treatment intention). Results: A total of 376 scans (151 patients) were included: Group A 9.3% (35 of 376 scans), Group B 77.4% (291 of 376 scans), and Group C 13.3% (50 of 376 scans). Significant stage migration, predominantly upstag-ing, occurred in Group A (45.7%) and Group C (28.0%). Changes in clinical management were observed in 120 scans (31.9%), of which 66 were major and 54 were minor. The largest proportion of<sup>18</sup>F-FDG-PET/ CT-induced management changes were observed in Group A (57.1%), most commonly a shift from curative to palliative treatment intention due to upstaging. Interpretation: Our study indicates the clinical utility of <sup>18</sup>F-FDG-PET/CT in BC restaging and changes in clinical management; the latter observed in approximately one-third of all cases.</p>}},
  author       = {{Skarping, Ida}},
  issn         = {{0284-186X}},
  keywords     = {{F-FDG; Breast cancer; clinical management; imaging; PET/CT; staging}},
  language     = {{eng}},
  pages        = {{669--677}},
  publisher    = {{Taylor & Francis}},
  series       = {{Acta Oncologica}},
  title        = {{<sub>18</sub> F-FDG-PET/CT in breast cancer imaging : Restaging and Implications for treatment decisions in a clinical practice setting}},
  url          = {{http://dx.doi.org/10.2340/1651-226X.2024.40003}},
  doi          = {{10.2340/1651-226X.2024.40003}},
  volume       = {{63}},
  year         = {{2024}},
}