Abstract P5-02-03: Evaluation of pathological malignancy grade and neoplastic progress of breast cancer using dedicated breast positron emission tomography
Authors: Masumoto N , Kadoya T , Nishina M , Kimura Y , Suzuki E , Sueoka S , Goda N , Sasada S , Kajitani K , Emi A , Haruta R , Kataoka T , Okada M 
Published: February 2018

Background: Dedicated breast positron emission tomography (DbPET)provides detailed high resolution images of the breast and enables quantitative assessment using standard uptake values (SUVs). We aimed to determine whether DbPET can predict the pathological malignancy grade and neoplastic progress of breast cancer compared with whole body (WB) PET.

Methods: We investigated 196 consecutive patients with invasive breast cancerwho underwent concurrent Db- and WB-PET from January 2016 to March 2017. All Db- and WB-PET were quantified based on SUVs. We also investigated pathological features of breast cancer who had a ring-like uptake (RU) without central FDG accumulation on DbPET.

Results:

The associations between the SUVs for DB- and WB-PET and the pathological factors in breast cancerCharacteristicSUV WBPETDbPET Mean ± SDpMean ± SDpall3.6 ± 3.4 9.4±7.9 Tumor size    ≤2.0 cm2.2±1.6&lt;0.0016.5±5.2&lt;0.001&gt;2.0 cm5.5±4.1 13.3±9.2 LN    Negative3.1±3.3&lt;0.0018.4±7.8&lt;0.001Positive4.9±3.2 11.8±7.7 NG    1 or 22.4±2.1&lt;0.0016.6±5.9&lt;0.00135.1±4.0 12.7±8.7 Ki67    &lt; 201.8±1.1&lt;0.0015.2±3.3&lt;0.001≥ 204.4±3.7 11.4±8.6 ER    positive3.4±3.30.028.8±7.60.006negative5.2±3.6 13.5±8.6 HER-2    positive4.6±3.10.0911.8±7.60.04negative3.4±3.4 9.0±7.9 Sub type vs Lumnal A vs Lumnal ALuminal A1.8±1.1 5.2±3.3 Luminal B4.0±3.8&lt;0.00110.1±8.5&lt;0.001HER24.6±3.1&lt;0.00111.8±7.6&lt;0.001Triple negative5.3±3.8&lt;0.00113.8±9.2&lt;0.001

summarizes the association between SUVs for Db- and WB-PET and pathological factors inbreast cancer.SUVs on PET were significantly higher for the tumor size of &gt;2.0 cm than for tumor size ≤2.0 cm (p&lt;0.001), for LN-positive than for LN-negative (p&lt;0.001), for NG3 than for NG1-NG2 (p&lt;0.001), for higher Ki67 expression than for lower Ki67 expression (p&lt;0.001), and for ER-negative than for ER-positive (WBPET, p=0.02; DbPET, p=0.006). SUVs were significantly lower for Luminal A than for Luminal B, HER2, and triple-negative cancer (p&lt;0.001 for all three).SUVs for DbPET was significantly higher for HER2-positive than for HER2-negative (p=0.02).

The association between SUVs for breast cancer with and without RU on DbPETCharacteristicRU(-), nRU(+), npall17323 Tumor size   ≤2.0 cm1095&lt;0.001&gt;2.0 cm6418 LN   Negative1299&lt;0.001Positive4414 NG   1 or 210070.0237316 Ki67   &lt; 206130.03≥ 2011220 ER   positive152190.49negative214 HER-2   positive2620.38negative14721 Sub type  vs Lumnal ALuminal A493 Luminal B84150.02HER22620.81Triple negative1430.04

summarizes the association between SUVs for breast cancer with and without RU on DbPET. SUVs for breast cancer with RU on DbPET were significantly higher for the tumor size of &gt;2.0 cm than for tumor size ≤2.0 cm, for LN -positive than for LN-negative (p&lt;0.001), for NG3 than for NG1-2 (p=0.02), and for higher Ki67 expression than for lowerKi67 expression (p=0.03). SUVs were significantly lower for Luminal A than for Luminal B (p=0.02) and triple-negative cancer (p=0.04).

Conclusions: SUVs for DbPET were equal or superiorto WBPET in predicting the pathological malignancy grade and neoplastic progress in tumors. Furthermore, the presence of RU on DbPET can provide excellent predictive value for high-grade malignancy and might help to determine appropriate therapeutic strategies.

Citation Format: Masumoto N, Kadoya T, Nishina M, Kimura Y, Suzuki E, Sueoka S, Goda N, Sasada S, Kajitani K, Emi A, Haruta R, Kataoka T, Okada M. Evaluation of pathological malignancy grade and neoplastic progress of breast cancer using dedicated breast positron emission tomography [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-02-03.