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Detection of Breast Cancer in Women After Augmentation Mammoplasty Using Fluorine-18-Fluorodeoxyglucose-PET

Department of Internal Medicine, Division of Nuclear Medicine and Departments of Radiology and Surgery, University of Michigan Medical Center, Ann Arbor, Michigan

Correspondence: For correspondence or reprints contact: Richard L. Wahl, MD, Division of Nuclear Medicine, University of Michigan Medical Center, 1500 E. Medical Center Drive, B1G412, Ann Arbor, MI 48109-0028.

ABSTRACT

The purpose of thus study was to determine the feasibility of FDG-PET imaging in women with silicone implant augmentation mammoplasties where mammographic detection of breast cancers is challenging due to the implants' radiodensity, which can obscure tumor visualization. Methods: FDG-PET imaging was performed in two women with augmentation mammoplasties and small palpable breast abnormalities. Mammograms with and without breast displacement were also performed. Results: PET dearly demonstrated focal FDG accumulation in the suspicious breasts, corresponding to tumors of less than 1.5 cm in diameter. There was no degradation of image quality by the implants and no need for breast displacement views. By contrast, implant displacement mammograms were necessary to fully delineate the tumors. Conclusion: While mammograms with displacement views represent the initial choice for imaging the augmented breast, FDG-PET can image tumors in the augmented breast without implant displacement and without obvious degradation of image quality by the implant. FDG-PET warrants additional evaluation as an adjunctive study in the augmented breast, particularly when displacement mammographic views are not adequate or are impossible to perform due to peri-implant capsule formation.

Key Words: breast cancer • positron emission tomography • glucose analogs • augmentation mammoplasty • mammography • silicone implants • FDG

FOOTNOTES

^* Current address: Department of Radiology, Malmö General Hospital, Malmö, Sweden.