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Tumour markers and FDG PET/CT for prediction of disease relapse in patients with breast cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of the study was to assess the role of CA 15.3, CT and positron emission tomography (PET)/CT in patients with breast cancer and suspected disease relapse after primary treatment.

Methods

We studied 111 consecutive patients (mean age 61 ± 12 years) with previous breast cancer, already treated and with clinical or biochemical suspicion of disease relapse. All patients underwent CT and 18F-fluorodeoxyglucose (FDG) PET/CT. In all patients, the value of CA 15.3 was compared to PET/CT and CT. The final diagnosis of relapse was established by invasive and noninvasive follow-up and was compared with CA 15.3, CT and PET/CT results. Univariate and multivariate analyses were used to identify the independent predictors of disease relapse and receiver-operating characteristic (ROC) curve for the identification of optimal CA 15.3 cutoff.

Results

Of all patients, 40 (36%) showed an increased CA 15.3 value, CT was positive in 73 (66%), whereas at PET/CT imaging 64 (58%) showed positive findings for disease relapse. Of 40 patients with increased marker levels, 22 patients had positive CT and 30 positive PET/CT (55 vs 75%, p < 0.001). At the end of follow-up, recurrence occurred in 32 (29%) patients, 16 (50%) of whom showed high levels of CA 15.3. PET/CT predicted relapse in 26 (81%) patients, whereas CT correctly identified 23 (72%). At univariate analysis, recurrence was significantly associated with high CA 15.3 values (p < 0.05) and positive PET/CT (p < 0.005). At multivariable analysis only positive PET/CT remained an independent predictor of disease relapse (p < 0.05). ROC analysis showed an optimal cutoff point for CA 15.3 of 19.1 U/ml (AUC 0.65, p < 0.01) to individuate positive PET/CT.

Conclusion

FDG PET/CT is more sensitive than CT and CA 15.3 in the evaluation of disease relapse. PET/CT might be considered a complementary imaging technique during follow-up in patients with breast cancer.

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Authors and Affiliations

  1. Radiotherapy and Nuclear Medicine Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata, 64, 35128, Padova, Italy

    Laura Evangelista, Lorenzo Vinante, Anna Rita Cervino, Michele Gregianin, Giorgio Saladini & Guido Sotti

  2. Departments of Biomorphological and Functional Imaging, University of Naples “Federico II”, Naples, Italy

    Laura Evangelista

  3. Oncology Unit, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy

    Zora Baretta & Cristina Ghiotto

Authors
  1. Laura Evangelista
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  2. Zora Baretta
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  3. Lorenzo Vinante
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  4. Anna Rita Cervino
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  5. Michele Gregianin
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  6. Cristina Ghiotto
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  7. Giorgio Saladini
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  8. Guido Sotti
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Correspondence to Laura Evangelista.

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Evangelista, L., Baretta, Z., Vinante, L. et al. Tumour markers and FDG PET/CT for prediction of disease relapse in patients with breast cancer. Eur J Nucl Med Mol Imaging 38, 293–301 (2011). https://doi.org/10.1007/s00259-010-1626-7

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  • DOI: https://doi.org/10.1007/s00259-010-1626-7

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