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Axillary Lymph Node-to-Primary Tumor Standard Uptake Value Ratio on Preoperative F-18-FDG PET/CT: A Prognostic Factor for Invasive Ductal Breast Cancer

Title
Axillary Lymph Node-to-Primary Tumor Standard Uptake Value Ratio on Preoperative F-18-FDG PET/CT: A Prognostic Factor for Invasive Ductal Breast Cancer
Authors
Kim, Young HwanYoon, Hai-JeonKim, YemiKim, Bom Sahn
Ewha Authors
김범산김예미윤혜전
SCOPUS Author ID
김범산scopus; 김예미scopus; 윤혜전scopus
Issue Date
2015
Journal Title
JOURNAL OF BREAST CANCER
ISSN
1738-6756JCR Link2092-9900JCR Link
Citation
vol. 18, no. 2, pp. 173 - 180
Keywords
Breast neoplasmsFluorodeoxyglucose F18Lymph nodesPrognosis
Publisher
KOREAN BREAST CANCER SOC
Indexed
SCIE; SCOPUS; KCI WOS scopus
Abstract
Purpose: This study assessed the axillary lymph node (ALN)-to-primary tumor maximum standard uptake value (SUVmax.) ratio (ALN/T SUV ratio) in invasive ductal breast cancer (IDC) on preoperative F-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) to determine the effectiveness in predicting recurrence-free survival (RFS). Methods: One hundred nineteen IDC patients (mean age, 50.5 +/- 10.5 years) with pathologically proven ALN involvement without distant metastasis and preoperative FDG PET/CT were enrolled in the study. SUVmax values of the ALN and primary tumor were obtained on FDG PET/CT, and ALN/T SUV ratio was calculated. Several factors were evaluated for their effectiveness in predicting RFS. These included several parameters on FOG PET/CT as well as several clinicopathological parameters: pathologic tumor/node stage; nuclear and histological grade; hormonal state; status with respect to human epidermal growth factor receptor 2, mindbomb E3 ubiquitin protein ligase 1 (MIB-1), and p53; primary tumor size; and ALN size. Results: Among 119 patients with breast cancer, 17 patients (14.3%) experienced relapse during follow-up (mean follow-up, 28.4 months). The ALN/T SUV ratio of the group with disease recurrence was higher than that of the group without recurrence (0.97 +/- 1.60 and 0.45 +/- 0.40, respectively, p=0.005). Univariate analysis showed that the primary tumor SUVmax, ALN SUVmax, ALN/T SUV ratio, ALN status, nuclear and histological grade, estrogen receptor (ER) status, and MIB-1 status were predictors for RFS. Among these variables, ALN/T SUV ratio with hazard ratio of 4.20 (95% confidence interval [CI], 1.74-10.13) and ER status with hazard ratio of 4.33 (95% CI, 1.06-17.71) were predictors for RFS according to multivariate analysis (p=0.002 and p=0.042, respectively). Conclusion: Our study demonstrated that ALN/T SUV ratio together with ER status was an independent factor for predicting relapse in IDC with metastatic ALN. ALN/T SUV ratio on preoperative FDG PET/CT may be a useful marker for selecting IDC patients that need adjunct treatment to prevent recurrence.
DOI
10.4048/jbc.2015.18.2.173
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의학전문대학원 > 의학과 > Journal papers
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