RT Journal Article
SR Electronic
T1 Brown fat activation demonstrated on FDG PET/CT predicts survival outcome
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 607
OP 607
VO 61
IS supplement 1
A1 Sonya Park
A1 Yong An Chung
YR 2020
UL http://jnm.snmjournals.org/content/61/supplement_1/607.abstract
AB 607Objectives: Dysregulation of endocrine function and disturbed expression profile of adipokines intimately connect obesity and breast cancer. Brown adipose tissue (BAT), which dissipates energy, is thought to be protective against obesity, but may also play a key role in breast cancer progression. The purpose of this study was to compare the survival of patients with and without BAT activity on FDG PET/CT. PET/CT exams from 3937 breast cancer patients were retrospectively reviewed for bilateral symmetric elongated FDG activity in the neck and chest, typical of BAT activation. A control group of age-matched (±1 year) breast cancer patients who underwent PET/CT the same week were also enrolled for comparison. Kaplan-Meier curves of progression-free survival (PFS) and overall survival (OS) for BAT positive patients and the control group. Further subanalysis was performed to account for the hormonal changes associated with menopause. 2.0% (80/3937) of the breast cancer patients who underwent PET/CT demonstrated BAT activation, and 80 additional patients were analyzed for comparison as the group without BAT activity. Mean follow-up was 76 months (range 1-225 months). There were 4 recurrences in the BAT group, compared to 12 in the control. The mean PFS for the BAT group was 127 months, which was significantly lower than the mean PFS of 180 months in the control (p=0.047). There were only 2 cancer-related deaths during the study, both in the control group, although there were too few events to reach statistical significance. Subanalysis of premenopausal women again showed longer PFS for the BAT group (129 vs. 196 months, p=0.095) while no difference was found in postmenopausal women (mean 102 vs. 135 months, p=0.360). Presence of BAT activity was also a significant predictor variable for PFS on Cox regression. Patients with BAT activity showed longer progression-free survival than those without, emphasizing the need for further evaluation of its role in metabolism, treatment response, tumor microenvironment and long-term prognosis. This prognostication trend held true for premenopausal women but not postmenopausal women, suggesting the impact of age related hormonal changes on active BAT.