Incidental Breast Lesions Identified by 18F-FDG PET/CT: Which Clinical Variables Differentiate between Benign and Malignant Breast Lesions?

• Published in: Journal of breast cancer 2015, 18(1), 73, pp.73-79
• Main Authors: Shin, Kyung Min, Kim, Hye Jung, Jung, Su Jin, Lim, Hyo Soon, Lee, Sang Woo, Cho, Seung Hyun, Jang, Yun-Jin, Lee, Hui Joong, Kim, Gab Chul, Jung, Jin Hyang, Park, Ji Young
• Format: Article
• Language: English
• Subjects: Original; 일반외과학
• ISSN: 1738-6756; 2092-9900
• DOI: 10.4048/jbc.2015.18.1.73

Purpose: The aim of our study was to evaluate the risk of malignancyand to determine which clinical variables differentiate betweenbenign and malignant focal breast lesions found incidentallyon 18F-flourodeoxyglucose positron emission tomographyand computed tomography (FDG PET/CT). Methods: FromMarch 2005 to October 2011, 21,224 women with no history ofbreast cancer underwent FDG PET/CT at three university-affiliatedhospitals. We retrospectively identified 214 patients with incidentalfocal hypermetabolic breast lesions and grouped theminto benign and malignant lesion groups. Of the 214 patients, 82patients with 91 lesions were included in this study. All lesionswere confirmed histologically or were assessed by follow-up imagingfor greater than 2 years. The patient age, maximum standardizeduptake value (SUVmax), lesion size on ultrasonography(US), and Breast Imaging-Reporting and Data System (BI-RADS)category on US in conjunction with mammography were comparedbetween the groups. Multivariate logistic regression analysiswas used to identify independent factors associated withmalignancy. Results: The risk of malignancy was 29.7% (27/91)in breast incidentalomas detected by FDG PET/CT. The univariateanalysis showed that the patient age, SUVmax, tumor size,and BI-RADS category differed significantly between the malignantand benign groups. The multivariate analysis showed thatthe BI-RADS category was the only significant factor differentiatingbenign from malignant lesions (p=0.002). Conclusion: BIRADScategory based on US in conjunction with mammographywas the only useful tool to differentiate between malignant andbenign lesions in breast incidentalomas on FDG PET/CT. KCI Citation Count: 12