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Research ArticleContinuing Education

The Current and Future Roles of Precision Oncology in Advanced Breast Cancer

Heather Jacene, Eric Dietsche and Jennifer Specht
Journal of Nuclear Medicine March 2024, 65 (3) 349-356; DOI: https://doi.org/10.2967/jnumed.122.264882
Heather Jacene
1Imaging/Radiology, Dana-Farber/Brigham Cancer Center, Boston, Massachusetts;
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Eric Dietsche
2Department of Radiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island; and
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Jennifer Specht
3Fred Hutch Cancer Center, Divisions of Hematology and Oncology and of Clinical Research, Department of Medicine, University of Washington, Seattle, Washington
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    FIGURE 1.

    66-y-old woman with de novo metastatic, ER-positive lobular breast cancer. 18F-FES PET/CT shows more lesions than 18F-FDG PET/CT. ER tumor heterogeneity is also demonstrated with both 18F-FDG–negative, 18F-FES–positive lesions (white arrows) and 18F-FDG–positive, 18F-FES–negative lesions (red arrows).

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    TABLE 1.

    Major Molecular Subtypes of Breast Cancer (9)

    Molecular subtypeProportion of breast cancer4-y estimated survival
    HR-positive/HER2-negative66.6%92.5%
    HR-positive/HER2-positive9.7%90.3%
    HR-negative/HER2-positive4.3%82.7%
    Triple-negative10.8%77.0%
    • HR = hormone receptor.

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    TABLE 2.

    Description of T, N, and M Stages for Breast Cancer (10)

    T stageN stageM stage
    Tx: primary not assessableNx: not assessableM0: no distant metastases
    T0: no evidence of primaryN0: no regional LNcM0(i+): tumor cells on circulating blood markers, marrow, or nonregional nodal tissue < 0.2 mm
    Tis: ductal carcinoma in situN1: ipsilateral level I or II axillary LNM1: distant metastases
    T1: ≤20 mmN2: clinically fixed/matted ipsilateral level I or II axillary LN or clinically detected ipsilateral internal mammary LN
    T2: >20 but ≤50 mmN3: ipsilateral level III axillary LN, clinically detected ipsilateral internal mammary LN with level I or II axillary LN, or ipsilateral supraclavicular LN
    T3: >50 mm
    T4: any size with direct chest wall or skin extension
     T4d: IBC
    • LN = lymph node.

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    TABLE 3.

    TNM Stages for Early, Locally Advanced, and Metastatic Breast Cancer (10)

    CategoryStageTNM description
    Early1AT1N0M0
    1BT0/T1, N1mi, M0
    2AT0/or T1, N1, M0
    T2, N0, M0
    2BT2, N1, M0
    Locally advanced2BT3, N0, M0
    3AT0/T1/T2, N2, M0
    T3, N1/N2, M0
    3BT4, N0, N1/N2, M0
    3CAny T, N3, M0
    Metastatic4Any T, Any N, M1
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Journal of Nuclear Medicine: 65 (3)
Journal of Nuclear Medicine
Vol. 65, Issue 3
March 1, 2024
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The Current and Future Roles of Precision Oncology in Advanced Breast Cancer
Heather Jacene, Eric Dietsche, Jennifer Specht
Journal of Nuclear Medicine Mar 2024, 65 (3) 349-356; DOI: 10.2967/jnumed.122.264882

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The Current and Future Roles of Precision Oncology in Advanced Breast Cancer
Heather Jacene, Eric Dietsche, Jennifer Specht
Journal of Nuclear Medicine Mar 2024, 65 (3) 349-356; DOI: 10.2967/jnumed.122.264882
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  • Article
    • Abstract
    • ANATOMIC AND PROGNOSTIC INDICATORS OF BREAST CANCER
    • BREAST CANCER STAGING
    • MOLECULAR IMAGING AS A BIOMARKER: KEY TERMINOLOGY
    • FUTURE DIRECTIONS OF MOLECULAR IMAGING AND THERAPY IN LABC
    • CONCLUSION
    • ACKNOWLEDGMENTS
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Keywords

  • breast cancer
  • molecular imaging
  • precision
  • FDG
  • FES
  • PET
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