18F FDG PET/CT in breast cancer: Incremental value over the conventional imaging modalities in initial and subsequent treatment strategy

Introduction and aim. To investigate the potential outperformance of 18F FDG PET/CT over conventional imaging modalities in various clinical settings in patients with breast cancer and the ultimate impact on clinical management. Method. Of a total 256 patients with breast cancer who were referred to PET/CT division, Masih Daneshvari Hospital between May 2013 and Mar. 2016, 123 cases were included. Definitely-positive PET/CT findings and related impact on clinical management compared with the results of baseline imaging modalities including CT scan, sonography, bone scan, C-X ray, MRI, MRM and mammography retrospectively. The most typical imaging pattern was considered as the reference standard. Results. Eleven point thirty-eight percent (14) and 88.62% (109) out of 123 patients were referred for staging and restaging/recurrence/surveillance B, respectively. PET/CT findings results in a significant change in initial and subsequent patients management in 42.9% and 44% of patients, detailed as 21.4% and 29.6% additional nodal detection rate, 21.4% and 28.7% change in N staging, 28.6 and 53.2% additional distant metastatic lesion and 14.3% and 44% change in M staging, respectively. Locoregional detection rate in biopsy proven recurrence was 100%. Conclusion. 18 F FDG PET/CT may play a complementary role in initial and subsequent treatment strategy in patients with breast cancer and may be considered as the imaging modality of choice for accurate assessment of nodal and distant metastasis in clinical practice