Objective: To evaluate the performance of 18F-FDG PET/CT in the detection of primary breast cancer, and the staging of regional lymph nodes.
Methods: Twenty four females with highly suspected breast cancer, underwent PET/CT imaging of the breast preoperatively. All the patients received no treatment at admission. Three nuclear medicine physicians analyzed the image and made the diagnosis. 32 breast lesions were evaluated by histology, revealing 25 breast carcinomas and 7 benign pathological changes. 23 patients had histological diagnosis of the breast tumor and regional lymph nodes.
Results: 20 of 25 breast carcinomas were successfully diagnosed by FDG-PET/CT. The sensitivity was 80% and specificity was 71.4%. No Tis breast carcinoma was detected. 75.0% of T1 breast carcinomas were detected, and with 85.7% of stage T2, 100.0% of T3. 10 patients were proved to have lymph node metastasis, and PET/CT got a sensitivity of 60.0%. As to a suspicious distant metastasis, PET/CT convinced the diagnosis.
Conclusion: As a noninvasive technique, FDG PET/CT appears to be a useful method in staging patient with breast cancer, especially in cases in which the lesion is hard to predict by routine examination. But the accuracy of FDG PET/CT seems to be not high enough to identify patients who might avoid axillary lymph nodes dissection. In the detection of breast lesions, PET/CT doesn't seem to have a high sensitivity, especially in early stage breast cancers. The high cost and the space resolution limit its use as a routine diagnostic method of breast cancer.