Relationship Between Staging FDG PET/CT Findings and Distribution of Metastatic Sites in Metastatic Breast Cancer

INTRODUCTION: We aimed to investigate the relationship between staging FGD PET/CT findings and metastasis distribution and histopathological features of primary tumor in patients with metastatic breast cancer at diagnosis time.
METHODS: Eighty patients with breast cancer who underwent F-18 FDG PET/CT for staging were included. The patients with newly diagnosed metastatic disease were included. Age and histopathological features of the primary tumor were recorded. The distant metastases sites, the numbers of metastasis and metastatic axillary/non-axillary lymph nodes were reviewed from PET/CT. The maximum standardized uptake(SUVmax) values were measured.
RESULTS: All patients(n: 80,mean age 58.0±14.4) had invasive breast carcinoma. Age was significantly related to the presence of lung metastases(p=0.006, mean ages 54y vs 64y).Only liver metastasis had a significant relationship with primary tumor SUVmax values and tumor molecular profile. The patients with HR+/HER2- (7/60patients, 11.7%) had relatively less liver metastasis than with the other subtypes (9/20patients, 45%). There were significant associations between SUVmax of axillary lymph node(p=0.02), primary tumor(p=0.001), liver metastasis(p=0.02) and tumor subtypes. The numbers of distant metastasis were related with the numbers of axillary lymph node metastasis(p=0.02) and the highest SUVmax of distant metastasis(p=0.001).
DISCUSSION AND CONCLUSION: Accurate detection of distant metastases in breast cancer at the time of diagnosis is of great importance in terms of treatment planning and prognosis of the disease. FDG PET/CT is a very reliable modality in determining distant metastasis and their distribution, and as a result of our study, we suggest that PET/CT findings can predict factors with prognostic importance.

Metastatik Meme Kanserinde Evreleme FDG PET/BT Bulgularýnýn Metastatik Bölge Daðýlýmý ile Ýliþkisi

GÝRÝÞ ve AMAÇ: Taný anýnda metastatik meme kanserinde evreleme FDG PET/BT bulgularýnýn metastaz daðýlýmlarý ve tümör histopatolojik özellikleri ile iliþkisini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Meme kanseri tanýsýyla bölümümüzde evreleme FDG PET/BT görüntülemesi yapýlan 80 hasta çalýþmaya dahil edildi. Daha önce tedavi almamýþ hastalar çalýþmaya alýndý. Yaþ, primer tümörün histopatolojik özellikleri geriye dönük olarak kaydedildi. Uzak metastaz alanlarý, metastaz odak sayýlarý, aksilla-aksilla dýþý metastatik lenf nodlarýi PET/BT görüntülerinden tarandý. Standart maksimum tutulum (SUVmaks) deðerleri hesaplandý.
BULGULAR: Tüm hastalar (n: 80, ort. Yaþ 58.0±14.4) invaziv meme kanseri tanýlý idi. Hasta yaþý akciðer metastazý ile iliþkiliydi(p=0.006, ort yaþlar 54, 64). Uzak metastaz alanlarýndan sadece karaciðer metastazýnýn primer tümör SUVmaks deðeri ve tümör moleküler profili ile iliþkisi olduðu gösterildi. Karaciðer metastaz sýklýðý HR+/HER2- olan hastalarda (7/60, %11.7) diðer tümör subtipleri (9/20, %45) olanlara göre daha düþüktü. Primer tümör (p=0.001), aksilla lenf nodu(p=0.02) ve karaciðer metastaz(p=0.02) SUVmaks deðerleri ile tümör subtipleriarasýnda anlamlý iliþki gözlendi.Uzak metastaz alan sayýsý ile metastatik aksiller lenf nodu sayýsý (p=0.02) ve en yüksek uzak metastaz SUVmaks deðeri (p=0.001) arasýnda anlamlý iliþki gözlendi.
TARTIÞMA ve SONUÇ: Meme kanserinde taný anýnda metastaz varlýðýnýn doðru olarak saptanmasýnýn tedavi planý ve hastalýðýn seyri açýsýndan önemi büyüktür. FDG PET/BT uzak metastazý ve hatta daðýlýmýný belirlemede oldukça güvenilir bir modalite olup, çalýþamamýz sonunda FDG PET/BT bulgularýnýn prognostik öneme sahip faktörleri öngörebileceðini düþünmekteyiz.