RT Journal Article SR Electronic T1 Baseline Tumor 18F-FDG Uptake and Modifications After 2 Cycles of Neoadjuvant Chemotherapy Are Prognostic of Outcome in ER+/HER2− Breast Cancer JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 824 OP 831 DO 10.2967/jnumed.115.154138 VO 56 IS 6 A1 David Groheux A1 Alice Sanna A1 Mohamed Majdoub A1 Patricia de Cremoux A1 Sylvie Giacchetti A1 Luis Teixeira A1 Marc Espié A1 Pascal Merlet A1 Anne de Roquancourt A1 Dimitris Visvikis A1 Mathieu Hatt A1 Matthieu Resche-Rigon A1 Elif Hindié YR 2015 UL http://jnm.snmjournals.org/content/56/6/824.abstract AB This study investigated whether 18F-FDG PET/CT performed at baseline and during neoadjuvant chemotherapy (NAC) was able to early depict estrogen receptor–positive/human epidermal growth factor receptor 2–negative (ER+/HER2−) breast cancer patients with poor clinical outcome. Methods: The NAC regimen consisted of 4 cycles of epirubicin plus cyclophosphamide, followed by 4 courses of docetaxel. The patients underwent 18F-FDG PET/CT at baseline and after 2 cycles of chemotherapy. After completion of NAC, all patients had breast surgery with axillary lymph node dissection. We assessed the impact of 2 PET parameters, maximum standardized uptake values (SUVmax) and total lesion glycolysis, on event-free survival (EFS). Results: Ninety-eight consecutive patients with clinical stage II or III ER+/HER2− breast cancer were included. 18F-FDG PET/CT revealed distant metastases in 14 patients (14%). Overall survival was significantly shorter in these patients than in the 84 patients classified as M0 at baseline 18F-FDG PET/CT (P < 0.001). In M0 patients, a high SUVmax at baseline was associated with shorter EFS (P < 0.001). Twelve patients had a tumor SUVmax of 10 or greater and a 3-y EFS of 49% (vs. 92% in patients with baseline SUVmax < 10). A low change in SUVmax between 18F-FDG PET/CT examination before starting NAC and after the second cycle of chemotherapy was also associated with recurrence (P = 0.033), as was a low change in total lesion glycolysis (P < 0.001). Contrarily to PET-based prediction, the extent of pathologic response after completion of NAC (partial/complete vs. nonresponders) was poorly correlated to the risk of relapse. Conclusion: Baseline tumor 18F-FDG uptake and modifications after 2 cycles of NAC are prognostic of outcome in patients with ER+/HER2− breast cancer.