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Impact of Whole-Body ¹⁸F-FDG PET on Staging and Managing Patients with Breast Cancer: The Referring Physician’s Perspective

Ahmanson Biological Imaging Center/Nuclear Medicine Clinic, Department of Molecular and Medical Pharmacology, UCLA School of Medicine, University of California, Los Angeles; and Northern California PET Imaging Center, Sacramento, California

FDG PET has emerged as an important clinical imaging modality for diagnosing and staging cancer. However, the impact of FDG PET on staging and managing patients with breast cancer from the referring physician’s point of view is unknown. Methods: The referring physicians of 160 breast cancer patients received standardized questionnaires inquiring if and how PET findings altered their patient’s stage and their clinical management decisions. Management changes were classified as intermodality if the change was from one modality to another (e.g., medical to surgical, surgical to radiation, medical to no treatment, and vice versa) or as intramodality if the change was within the same modality (e.g., altered medical or radiotherapy approach). Results: Fifty of the 160 surveys were completed (31% response rate). PET changed the clinical stage in 36% of patients (28% upstaged, 8% downstaged) and resulted in intermodality changes in 28% of patients and intramodality changes in 30% of patients. Conclusion: The results of this prospective survey show that FDG PET has a major impact on the management of breast cancer patients, influencing both clinical stage and management in more than 30% of patients.

Key Words: PET • breast cancer • staging • survey

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