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Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

Radiological Investigation III: Pulmonary Angiogram and PET Scan

Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...

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Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
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Axillary Pathological Complete Response After Neoadjuvant Therapy in cN1-2 Breast Cancer: An Internally Validated

Mustafa Berkeşoğlu1, Gözde Arslan2, Ferah Tuncel3

  • 1Department of General Surgery, Faculty of Medicine, Mersin University, 33110 Mersin, Türkiye.

Current Oncology (Toronto, Ont.)
|December 24, 2025
PubMed
Summary

A new nomogram predicts axillary pathological complete response (pCR) in node-positive breast cancer patients after neoadjuvant systemic therapy (NAST). This tool combines tumor biology, PET/CT response, and nodal features to aid in de-escalation strategies.

Keywords:
PERCISTPET/CTaxillary lymph nodede-escalationneoadjuvant therapynomogramsentinel lymph nodetriple-negative breast cancer

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Area of Science:

  • Oncology
  • Radiology
  • Medical Imaging

Background:

  • Accurate prediction of axillary pathological complete response (pCR) is crucial for de-escalating axillary treatment in breast cancer patients receiving neoadjuvant systemic therapy (NAST).
  • Clinically node-positive (cN1-2) breast cancer patients often undergo extensive axillary staging, but identifying those achieving pCR (ypN0) can spare them morbidity.

Purpose of the Study:

  • To develop and internally validate a nomogram for estimating axillary pCR (ypN0) after NAST in clinically node-positive breast cancer.
  • To identify key predictors of axillary pCR to inform risk stratification for axillary de-escalation.

Main Methods:

  • Retrospective analysis of 144 clinically node-positive breast cancer patients treated with NAST.
  • Standardized pre- and post-NAST 18F-FDG PET/CT and axillary staging (SLNB, TAD, or ALND).
  • Multivariable logistic regression analysis to identify independent predictors of ypN0, followed by nomogram construction.

Main Results:

  • Axillary pCR (ypN0) was achieved in 51.4% of patients.
  • Independent predictors of ypN0 included triple-negative subtype, ≥80.70% Modified PERCIST reduction, tumor-to-axilla SUVmax ratio ≥1.21, and residual breast tumor size <0.5 mm.
  • Conglomerate/matted nodal morphology at diagnosis was inversely associated with ypN0. The nomogram demonstrated good internal discrimination (AUC 0.857).

Conclusions:

  • The developed nomogram, integrating tumor biology, PET/CT response, and nodal features, shows promise for risk stratification in axillary de-escalation after NAST.
  • Prospective external validation is essential before clinical implementation.
  • The tool is currently hypothesis-generating and not a stand-alone decision aid for routine practice.