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18F-Fluorodeoxyglucose positron emission tomography optimizes neoadjuvant chemotherapy for primary breast cancer to achieve pathological complete response

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Abstract

Background

To assess the usefulness of positron emission tomography combined with computed tomography using 18F-fluorodeoxyglucose (FDG PET/CT) for optimizing chemotherapy during neoadjuvant chemotherapy for primary breast cancer.

Methods

One hundred and eight patients (110 tumors) with breast cancer (≥2 cm, stages II and III) received neoadjuvant chemotherapy consisting of an anthracycline-based regimen and taxane. The maximal value of the baseline standardized uptake value (SUV) and the change in SUV after four cycles of an anthracycline-based regimen relative to baseline SUV were assessed for predicting pathological complete response (pCR) after sequential taxane.

Results

Tumors with pCR had significantly higher baseline SUV (9.3 ± 3.7 SD) compared to those with non-pCR (7.2 ± 3.8 SD) (p = 0.02), but there was a considerable overlap between two groups. On PET scan after four cycles of chemotherapy, thirty-three patients (33.7%) with a 72.1% or greater reduction in SUV were considered as responders and the performance in predicting pCR had a sensitivity of 88.9% and specificity of 78.7%.

Conclusion

The baseline SUV could not be a useful indicator for predicting pCR due to the wide range in sensitivity. On the other hand, a relative change in SUV after completion of an anthracycline-based regimen could be useful for predicting pCR.

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Acknowledgments

This study was supported by the grants of Department of Breast Oncology, Saitama Medical University and Medical Research of National Defense Force.

Conflict of interest

No authors has any conflict of interest.

Author information

Authors and Affiliations

  1. Medical Service School, National Defense Force, 1-2-24 Ikejiri, Setagaya-ku, Tokyo, 154-0001, Japan

    Shigeto Ueda

  2. Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan

    Jiro Omata, Tomoyuki Moriya & Junji Yamamoto

  3. Department of Breast Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan

    Shigeto Ueda, Toshiaki Saeki, Takashi Shigekawa, Nobuko Fujiuchi, Misono Misumi & Hideki Takeuchi

  4. Department of Nuclear Medicine, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan

    Etsuko Imabayashi, Ichiei Kuji & Hiroshi Matsuda

  5. Department of Pathology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan

    Takaki Sakurai

  6. Department of Breast Oncology, Saitama Medical University Hospital, 38 Morohongo, Moroyama, Saitama, 350-0495, Japan

    Akihiko Osaki

  7. Tokorozawa PET Diagnostic Imaging Clinic, 7-5 Higashi-Sumiyoshi, Tokorozawa, Saitama, 359-1124, Japan

    Katsumi Tamura, Jiro Ishida & Yoshiyuki Abe

  8. Pathology Section, Clinical Laboratory Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Hitoshi Tsuda

Authors
  1. Shigeto Ueda
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  2. Toshiaki Saeki
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  3. Takashi Shigekawa
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  11. Takaki Sakurai
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  15. Yoshiyuki Abe
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  16. Etsuko Imabayashi
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Corresponding author

Correspondence to Toshiaki Saeki.

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Ueda, S., Saeki, T., Shigekawa, T. et al. 18F-Fluorodeoxyglucose positron emission tomography optimizes neoadjuvant chemotherapy for primary breast cancer to achieve pathological complete response. Int J Clin Oncol 17, 276–282 (2012). https://doi.org/10.1007/s10147-011-0287-2

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  • DOI: https://doi.org/10.1007/s10147-011-0287-2

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