Baseline FDG PET-CT imaging is necessary for newly diagnosed inflammatory breast cancer patients: a narrative review

Objective: To review and discuss the rationale behind performing baseline 18-fluorodeoxyglucose positron emission tomography-computed tomography imaging for staging of inflammatory breast cancer patients. Background: In the past three decades, the epidemiology of inflammatory breast cancer has resulted in separation of this entity from other breast cancer in staging and treatment. Advances in cancer imaging from 18-fluorodeoxyglucose positron emission tomography to 18-fluorodeoxyglucose positron emission tomography-computed tomography have now allowed for anatomic and functional correlation in evaluating extent of disease in cancer patients. Furthermore, studies throughout the past two decades have highlighted how 18-fluorodeoxyglucose positron emission tomography-computed tomography may play a role in staging inflammatory breast cancer patients given the uniqueness of this entity when compared to other breast cancers. Methods: Narrative overview of the literature summarizing findings in the literature from searches in computerized databases and authoritative texts. The use of 18-fluorodeoxyglucose positron emission tomography-computed tomography with respect to regional nodal staging and distant metastasis detection in inflammatory breast cancer patients is reviewed. In addition, an overview of studies conducted to date comparing the sensitivity and specificity of 18-fluorodeoxyglucose positron emission tomography-computed tomography for baseline staging in inflammatory breast cancer patients is also provided. Therapeutic influences and effect on overall survival is discussed. Conclusions: Baseline 18-fluorodeoxyglucose positron emission tomography-computed tomography allows for more optimal nodal staging, which has implications in prognosis and treatment of inflammatory breast cancer patients. It also allows for improved detection of metastasis on baseline presentation allowing therapy to potentially target these additional sites of disease.