TY - JOUR
T1 - Initial staging impact of fluorideoxyglucose positron emission tomography/computed tomography in locally advanced breast cancer
AU - Niikura, Naoki
AU - Liu, Jun
AU - Costelloe, Colleen M.
AU - Palla, Shana L.
AU - Madewell, John E.
AU - Hayashi, Naoki
AU - Yu, Tse Kuan
AU - Tokuda, Yutaka
AU - Theriault, Richard L.
AU - Hortobagyi, Gabriel N.
AU - Ueno, Naoto T.
PY - 2011/6
Y1 - 2011/6
N2 - Purpose. Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) may reveal distant metastases more accurately than conventional imaging (CT, skeletal scintigraphy, chest radiography). We hypothesized that patients diagnosed with stage III noninflammatory breast cancer (non-IBC) and IBC by conventional imaging with PET/CT have a better prognosis than patients diagnosed without PET/CT. Patients and Methods. We retrospectively identified 935 patients with stage III breast cancer in 2000-2009. We compared the relapse-free survival (RFS) and overall survival (OS) times of patients diagnosed by conventional imaging with those of patients diagnosed by conventional imaging plus PET/CT. Univariate and multivariate Cox proportional hazards regression models were used to assess associations between survival and PET/CT. Results. RFS and OS times were not significantly different between patients imaged with PET/CT and those imaged without PET/CT. However, the RFS time in IBC patients was significantly different between patients imaged with PET/CT and those imaged without PET/CT on both univariate (hazard ratio [HR], 0.43; p =.014) and multivariate (HR, 0.33; p =.004) analysis. There was a trend for a longer OS duration in IBC patients imaged with PET/CT. Conclusion. Among IBC patients, adding PET/CT to staging based on conventional imaging might detect patients with metastases that were not detected by conventional imaging. The use of conventional imaging with PET/CT for staging in non-IBC patients is not justified on the basis of these retrospective data. The use of conventional imaging plus PET/CT in staging IBC needs to be studied prospectively to determine whether it will improve prognosis.
AB - Purpose. Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) may reveal distant metastases more accurately than conventional imaging (CT, skeletal scintigraphy, chest radiography). We hypothesized that patients diagnosed with stage III noninflammatory breast cancer (non-IBC) and IBC by conventional imaging with PET/CT have a better prognosis than patients diagnosed without PET/CT. Patients and Methods. We retrospectively identified 935 patients with stage III breast cancer in 2000-2009. We compared the relapse-free survival (RFS) and overall survival (OS) times of patients diagnosed by conventional imaging with those of patients diagnosed by conventional imaging plus PET/CT. Univariate and multivariate Cox proportional hazards regression models were used to assess associations between survival and PET/CT. Results. RFS and OS times were not significantly different between patients imaged with PET/CT and those imaged without PET/CT. However, the RFS time in IBC patients was significantly different between patients imaged with PET/CT and those imaged without PET/CT on both univariate (hazard ratio [HR], 0.43; p =.014) and multivariate (HR, 0.33; p =.004) analysis. There was a trend for a longer OS duration in IBC patients imaged with PET/CT. Conclusion. Among IBC patients, adding PET/CT to staging based on conventional imaging might detect patients with metastases that were not detected by conventional imaging. The use of conventional imaging with PET/CT for staging in non-IBC patients is not justified on the basis of these retrospective data. The use of conventional imaging plus PET/CT in staging IBC needs to be studied prospectively to determine whether it will improve prognosis.
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U2 - 10.1634/theoncologist.2010-0378
DO - 10.1634/theoncologist.2010-0378
M3 - Article
C2 - 21632453
AN - SCOPUS:79959583800
SN - 1083-7159
VL - 16
SP - 772
EP - 782
JO - Oncologist
JF - Oncologist
IS - 6
ER -