Triple-negative breast cancer: early assessment with 18F-FDG PET/CT during neoadjuvant chemotherapy identifies patients who are unlikely to achieve a pathologic complete response and are at a high risk of early relapse

J Nucl Med. 2012 Feb;53(2):249-54. doi: 10.2967/jnumed.111.094045. Epub 2012 Jan 12.

Abstract

Triple-negative breast cancer, an aggressive subtype, represents 15% of invasive breast tumors. This prospective study investigated whether early changes in (18)F-FDG tumor uptake during neoadjuvant chemotherapy (NAC) can predict outcomes.

Methods: Twenty (M0) patients underwent (18)F-FDG PET/CT at baseline and after the second cycle. NAC was continued irrespective of PET results.

Results: At surgery, 6 patients had a pathologic complete response, whereas 14 had residual tumor. Four patients showed early relapse (in the 2 y after surgery). There were 11 metabolic responders and 9 nonresponders using a 42% decrease in maximum standardized uptake value as a cutoff. In nonresponding patients, the risk of residual tumor at surgery was 100% (vs. 45% in responders; P = 0.014), and the risk of early relapse was 44% (vs. 0%; P = 0.024).

Conclusion: A less than 42% decrease in (18)F-FDG uptake at 2 cycles means residual tumor at the end of NAC and a high risk of early relapse.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • Disease-Free Survival
  • Female
  • Fluorodeoxyglucose F18* / metabolism
  • Humans
  • Middle Aged
  • Multimodal Imaging*
  • Neoadjuvant Therapy*
  • Patient Selection
  • Positron-Emission Tomography*
  • Recurrence
  • Risk
  • Time Factors
  • Tomography, X-Ray Computed*
  • Treatment Outcome

Substances

  • Fluorodeoxyglucose F18