¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Features in Locally Advanced Breast Cancer...

¹⁸F-Fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) is now recognized as a staging investigation for locally advanced breast cancer. This retrospective review of data was performed to correlate the maximum standardized uptake value (SUV_max) of the primary tumor with the molecular subtype of breast cancer.

Patients with biopsy-proven, treatment naïve, Stage III breast cancer, for whom ¹⁸F-FDG PET/CT data and immunohistochemistry 4 was available were included in the study. Correlations were deduced between the SUV_max of primary tumor to the molecular subtypes.

Three hundred and two patients were included in the study. Fifty-two (17.2%) tumors were Luminal A (LA), 131 (43.4%) Luminal B (LB), 42 (13.9%) human epidermal growth factor receptor-2 enriched (HE), and 77 (25.5%) basal-like (BL). SUV_max of the primary tumor differed significantly between LA and other subtypes (SUV_max: LA Median 7.4, LB 11.65, HE 13.5, BL 15.35, P < 0.001). Estrogen receptor (ER) and progesterone receptor (PR) positivity were inversely correlated to the SUV_max of the primary (SUV_max: ER + Median 10.4, ER - 14.2, P < 0.001, PR + 9.65, PR - 13.9, P < 0.001). There was a strong positive correlation observed between Ki67 and SUV_max (Pearson Coefficient 0.408, P < 0.001). A SUV_max value of 9.65 was determined as a cutoff on receiver operating characteristic curve to differentiate between LA and other subtypes with a sensitivity of 92.3% and specificity of 70.6%.

SUV_max of primary showed a statistically significant difference between LA subtypes when compared to other subtypes. However, there was overlap of values in each subgroup and thus ¹⁸F-FDG PET/CT cannot be used to accurately assess the molecular characteristics of the tumor.