Abstract
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Objectives We have analyzed the relationship between FDG uptake of primary tumor and well-known prognostic parameters of breast cancer, and prognostic significance of primary tumor SUVmax (pSUVmax) and ipsilateral metastatic axillary lymph nodes SUVmax (nSUVmax).
Methods Fifty five women (mean age, 50.2±9.5) with invasive ductal breast cancer (IDC) underwent F-18 FDG PET/CT before treatment. The pSUVmax was compared with histopathological findings (nuclear grade, estrogen receptor; ER, progesterone receptor; PR, c-erbB2 receptor) and lymph node (LN) metastasis. And we evaluated the relationship of pSUVmax and nSUVmax with disease-free survival (DFS).
Results The pSUVmax value was significantly higher in patient with high score of nuclear grade (P<0.001), negative ER (P<0.001), negative PR (P<0.001), and positive LN metastasis (P<0.006) but not different according to c-erbB2 receptor status. Meanwhile, pSUVmax and nSUVmax was significantly higher in patients with disease progression compared to patients with disease free, during follow-up. A receiver operating characteristic curve demonstrated a pSUVmax of 6.6 (sensitivity 86.7%, specificity 82.5%, area under the curve 0.848) and an nSUVmax of 2.7 (sensitivity 100%, specificity 76.9%, area under the curve 0.913) to be the optimal cutoff for predicting DFS. In the survival analysis, patients with pSUVmax > 6.6 or nSUVmax > 2.7 showed significantly short DFS than patients with pSUVmax ≤ 6.6 and nSUVmax ≤ 2.7, during at least 21 months follow up (P<0.001).
Conclusions The pSUVmax correlated with some well-known prognostic factors in breast cancer. Furthermore pSUVmax and nSUVmax on initial F-18 FDG PET/CT could predict the prognosis in patient with IDC
SUVmax difference between disease progression group and disease free group