Abstract
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Objectives To explore the application of 18F-FDG PET-CT and the pathological response to neoadjuvant chemotherapy(NAC) in different molecular subtypes breast cancer .
Methods According to the St.Gallen International Expert Consensus, 211 patients with newly diagnosed breast cancer was divided into five different subtypes: luminal A, luminal B(HER-2 negative), luminal B(HER-2 positive), HER-2 over-expression, basal-like. 18F-FDG PET-CT was performed before NAC, and calculated the maximum standard uptake value (SUVmax). Comparison of the SUVmax, pathological efficient rate according to Miller and Payne grading system and pCR rate in different molecular subtypes.
Results All different molecular subtypes of breast cancer had positive 18F-FDG PET-CT imaging, the sensitivity was 100%. The SUVmax of HER-2 overexpression and Basal-like breast cancer was the highest, the next was successively luminal B(HER-2 negative) and luminal B(HER-2 positive), SUVmax of Luminal A breast cancer was the lowest(table1). A pathological effective was seen in 19 (70%) of 27 basal-like breast cancer, 36 (68%) of 53 luminal B(HER-2 positive),18 (62%) of 29 HER-2 overexpression, 27 (52%) of 52 luminal B(HER-2 negative), 21 (42%) of 50 luminal A. A complete pathological response was seen in 9 (33%) of 27 basal-like breast cancer, 6 (11%) of 53 luminal B(HER-2 positive), 5 (10%) of 52 luminal B(HER-2 negative), 3 (6%) of 50 luminal A, 1 (3%) of 29 HER-2 overexpression.
Conclusions The 18F-FDG metabolic of HER-2 overexpression and Basal-like breast cancer was the highest. Basal-like breast cancer was most sensitive to NAC. Luminal A was not sensitive to NAC, and the 18F-FDG metabolic of Luminal A breast cancer was the lowest.