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Preoperative PET/CT in early-stage breast cancer
Abstract
Background: The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and
computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer.
Patients and methods: A
total of 103 consecutive patients with newly diagnosed operable breast
cancer with tumors ≥2 cm were independently examined
preoperatively with conventional assessment
(mammography, breast/axillary ultrasound, chest X-ray and blood samples)
and PET/CT with no prior knowledge of the other.
Results: PET/CT identified a primary tumor in all but three patients (97%). PET/CT
solely detected distant metastases (ovary, bones and lung) in 6
patients and new primary cancers (ovary, lung) in another
two patients, as well as 12 cases of
extra-axillary lymph node involvement. In 15 patients (15%),
extra-axillary malignancy
was detected by PET/CT only, leading to an upgrade of initial staging in 14% (14/103) and ultimately a modification of planned treatment in 8% (8/103)
of patients.
Conclusions: PET/CT is a valuable tool to provide information on extra-axillary lymph node involvement, distant metastases and other occult primary
cancers. Preoperative 18F-fluorodeoxyglucose–PET/CT has a substantial impact on initial staging and on clinical management in patients with early-stage breast cancer with tumors
≥2 cm.
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