The value of surveillance FDG PET/CT in breast cancer

Objectives To investigate the value of surveillance PET/CT for detecting unexpected recurrence in breast cancer patients.

Methods PET/CT images done for restaging of confirmed and treated breast cancer patients from November 2003 to June 2009 were respectively reviewed. Patients with at least 6 months of follow-up with biopsy, serial PET/CT or other conventional imaging studies such as computed tomography, magnetic resonance imaging, mammography, ultrasound and bone scan were included. We excluded patients with distant metastasis on initial staging and or known recurrent tumor.

Results PET/CT images of 440 patients (439 female, 1 male; mean age 52 years) were included. PET/CT scans discovered recurrent or metastatic lesions in 35 patients. The overall sensitivity, specificity, and accuracy of PET/CT were 95.8%, 97.1%, and 97.1%. PET/CT and conventional imaging were both positive in 19 patients and both negative in 401 patients. 16 patients were PET/CT positive and conventional imaging negative, and 9 (56%) of these cases were confirmed with loco-regional recurrence or distant metastasis. Two of the recurrent tumors were found in the lungs, 2 in mediastinum, 2 in bone, 1 in liver, 1 in brain and another in axillary lymph node. Of the remaining 4 patients with PET/CT negative and conventional imaging-positive findings, none were diagnosed with recurrent tumor but one patient developed contralateral breast cancer.

Conclusions Surveillance PET/CT has a supplementary role in the follow-up of breast cancer patients