Abstract
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Objectives We investigated the association between the stage of axilla and structural and metabolic features of primary breast cancer on FDG PET-CT.
Methods 35 women with breast cancer were grouped according to age (25-88 y), tumor size (1-10.5 cm) and tumor max SUV (1.4-15.2) . The univariate associations between axillary nodal metastasis, age, tumor shape and location were tested using Fisher Exact test. Cochran-Armitage test was used to test whether rate of nodal metastasis increased with increase in tumor size and max SUV. Spearman correlation coefficients were calculated between node size (1-5.2 cm), node max SUV (1.1-16.2), age, tumor size and max SUV in patients with nodal metastasis. The associations among tumor shape and location and node max SUV were also tested using Kruskal Wallis test.
Results Univariate analysis showed that none of primary tumor features on PET-CT was significantly associated with nodal metastasis. Multivariable logistic regression demonstrated trends that: 1) spiculated tumors had a higher rate of axillary nodal metastasis; 2) outer upper breast tumors led to higher rate of nodal metastasis; 3) tumors with max SUV range 3.6-6.5 were more likely associated with axillary nodal metastasis. For patients with nodal metastasis, node size was highly correlated with node max SUV (r=0.70, p=0.002). Age, tumor size, shape, location and max SUV were not significantly correlated with the node max SUV for those patients with nodal metastases.
Conclusions Hypermetabolic, spiculated, UO breast tumors are predictive of axillary nodal metastasis.
Research Support H. Jadvar was partly supported by NIH/NCI Grant R01-CA111613.
- © 2009 by Society of Nuclear Medicine