Positron emission tomography in the staging and management of breast cancer

Background: Breast cancer is the commonest cause of cancer death in women in the Western world, and imaging is essential in its diagnosis and staging. Metabolic imaging is a novel approach to improving the detection of cancers, as malignant transformation of cells is often associated with increased...

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Bibliographic Details
Published in:British journal of surgery 2004-11, Vol.91 (11), p.1398-1409
Main Authors: Byrne, A. M., Hill, A. D. K., Skehan, S. J., McDermott, E. W., O'Higgins, N. J.
Format: Article
Language:English
Subjects:
Axilla
Biological and medical sciences
Breast Neoplasms - diagnostic imaging
Evidence-Based Medicine
Female
General aspects
Gynecology. Andrology. Obstetrics
Humans
Lymph Node Excision - methods
Lymphatic Metastasis
Mammary gland diseases
Medical sciences
Neoplasm Recurrence, Local
Neoplasm Staging - methods
Positron-Emission Tomography - methods
Tumors
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Summary:Background: Breast cancer is the commonest cause of cancer death in women in the Western world, and imaging is essential in its diagnosis and staging. Metabolic imaging is a novel approach to improving the detection of cancers, as malignant transformation of cells is often associated with increased metabolic activity. This review assesses the possible role of positron emission tomography (PET) as a single non‐invasive imaging modality to replace or complement current imaging and surgical practices in the diagnosis and staging of breast cancer. Methods and results: A Medline search was performed and articles were cross‐referenced with other relevant material. Evaluation of primary breast cancer with PET has shown a sensitivity of between 64 and 100 per cent and a specificity of 33–100 per cent; diagnostic accuracy appears to be related to tumour size. Difficulties arise in altered fluorodeoxyglucose uptake in lobular carcinoma, carcinoma in situ and benign inflammatory breast disease. In axillary staging, sensitivities of between 25 and 100 per cent have been reported, but with a false‐negative of up to 20 per cent. In the assessment of distant metastasis and asymptomatic patients with raised levels of tumour markers, PET was superior to conventional imaging modalities. Conclusion: PET is not a single diagnostic and staging tool that can replace current surgical, histological and radiological staging. Its main role in breast cancer lies in the investigation of metastatic disease and the evaluation of pathological response to various chemotherapeutic regimens. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Evaluates metastases and response to treatment
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.4791