Imaging for illuminating actionable pathways in breast cancer.

Area of Science:

• Nuclear medicine
• Oncology
• Radiopharmaceutical development

Background:

• Breast cancer (BC) management can be enhanced by nuclear medicine techniques.
• Positron emission tomography (PET) offers various radiopharmaceuticals targeting specific tumor characteristics.

Purpose of the Study:

• To review emerging opportunities in PET imaging for breast cancer.
• To highlight the future potential of PET in managing BC patients.

Main Methods:

• Review of current and emerging PET radiotracers for breast cancer.
• Analysis of tracers targeting tumor cells and the tumor micro-environment (TME).

Main Results:

• Beyond 2-deoxy-2-[18F]-fluoro-d-glucose (FDG), new tracers target specific BC characteristics.
• Human epidermal growth factor receptor-2 (HER2) and integrin tracers aid in selecting patients for targeted therapy.
• Fluoroestradiol (FES) PET assesses estrogen receptor (ER) status in metastatic ER+ BC.
• Fibroblast activation protein inhibitors (FAPi) PET visualizes the TME and offers theranostic potential.

Conclusions:

• Emerging PET tracers show promise for improved breast cancer diagnosis and treatment selection.
• Targeted PET imaging can overcome limitations of FDG-PET in specific BC subtypes.
• Novel tracers like FES and FAPi expand the utility of PET in breast cancer management.