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| Pre-neoadjuvant chemotherapy 18F-FDG PET/CT examination to evaluate the postoperative radiotherapeutic value in stage II-III breast cancer #br# |
| WEN Guanghua1, LOU Jingjing1, HUANG Kemin2, FENG Yanlin2. |
1.Department of Nuclear Medcine, Jinhua Municipal Central Hospital, Jinhua, 321000; 2.Department of Nuclear Medcine, the First People’s Hospital of Foshan, Foshan, 528000
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WEN Guanghua,LOU Jingjing,HUANG Kemin, et al. Pre-neoadjuvant chemotherapy 18F-FDG PET/CT examination to evaluate the postoperative radiotherapeutic value in stage II-III breast cancer #br# [J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2016, 46(1): 39-43.
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Abstract Objective: To evaluate postoperative radiotherapy with 18F-FDg PET/CT before neoadjuvant chemotherapy in breast cancer patient staging II and III. Methods: We retrieved the 18F-FDg PET/CT record of 309 breast cancer patients in our hospital from July 2009 to May 2013. Distant metastases were detected in 85 patients, and 224 patients were included in this study. Conventional regional staging consisted of fine needle aspiration and/or sentinel lymph node biopsy. According to the guideline of NCCN 2013, patients were classified as low-risk group (T2N0), intermediate-risk group (T0N1, T1N1, T2N1, T3N0), or high-risk group (T3N1, T4,TxN2, TxN3). The presence and number of FDg-avid nodes were evaluated and the proportion of patients that would be upstaged by 18F-FDg PET/CT, based on detection of ≥4 FDg-avid axillary nodes defined as petN2(4+) or occult petN3-disease. Results: 18F-FDg PET/CT detected occult N3-disease in 11.4% (4/35) of 35 lowrisk patients. In 123 intermediate-risk patients, 18F-FDg PET/CT detected≥4 FDg avid nodes in 20 patients and occult N3-disease in 16 patients, thereby finally upstaging 25.2% (31/123) of the patients. Conclusion: 18F-FDg PET/CT imaging before neoadjuvant chemotherapy can accurately assess the patient’s risk of recurrence. For the high-risk group of patients, 18F-FDg PET/CT can detect occult lymph nodes and provide powerful guarantee for ascertainment of the range of radiation field.
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