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Performance of [18F]FDG-PET/CT Imaging in First Recurrence of Invasive Lobular Carcinoma

Background: Invasive lobular carcinoma accounts for 10 to 15% of all breast cancers. The first objective of this retrospective study was to assess the diagnostic performance of FDG-PET/CT scanning in women previously treated for invasive lobular carcinoma with suspected first recurrence. The seconda...

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Autores principales: Bonnin, David, Ladoire, Sylvain, Briot, Nathalie, Bertaut, Aurélie, Drouet, Clément, Cochet, Alexandre, Alberini, Jean-Louis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10144846/
https://www.ncbi.nlm.nih.gov/pubmed/37109252
http://dx.doi.org/10.3390/jcm12082916
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author Bonnin, David
Ladoire, Sylvain
Briot, Nathalie
Bertaut, Aurélie
Drouet, Clément
Cochet, Alexandre
Alberini, Jean-Louis
author_facet Bonnin, David
Ladoire, Sylvain
Briot, Nathalie
Bertaut, Aurélie
Drouet, Clément
Cochet, Alexandre
Alberini, Jean-Louis
author_sort Bonnin, David
collection PubMed
description Background: Invasive lobular carcinoma accounts for 10 to 15% of all breast cancers. The first objective of this retrospective study was to assess the diagnostic performance of FDG-PET/CT scanning in women previously treated for invasive lobular carcinoma with suspected first recurrence. The secondary objectives were to evaluate the impact of PET/CT in a change in treatment and its prognostic value on specific survival. Methods: Patients in whom a PET/CT scan was performed from January 2011 to July 2019 in our Cancer Research Center were enrolled. Recurrence was suspected based on clinical symptoms, abnormal findings on conventional imaging, and/or elevated tumor markers. The diagnosis of recurrence was established by the oncologist after integration of all clinical, biological, histological, imaging, and follow-up data. Prognostic factors of recurrence as predicted by PET were determined using univariate logistic regression. KI67, mitotic index, or grade of mitosis were tested. Survival curves were compared using the log-rank test. Sixty-four patients (mean age: 60.3; SD = 12.4 years) were enrolled. The average time from initial diagnosis of the primary tumor to suspicion of recurrence was 5.2 ± 4.1 years. Forty-eight patients (75%) were judged to have recurrence by the oncologist: 7 local and 41 metastatic, with mainly bone (n = 24), lymph node (n = 14) and liver (n = 10) metastases. Results: Sensitivity, specificity, and positive and negative predictive values of PET/CT to predict recurrence were, respectively: 87%, 87%, 95%, and 70%. SUVmax at recurrence sites was generally high (mean: 6.4; SD = 2.9). False negative PET/CT results occurred with local (n = 2), peritoneal (n = 2), meningeal (n = 1), or bladder (n = 1) recurrences. In 40 patients with available histopathological data from suspected sites of recurrence, 30 PET/CT were true positive. In four patients, primary lung (n = 1) or gastric (n = 1) tumors or lymphomas (n = 2) were found. The detection of a recurrence resulted in a change in treatment in 44/48 patients (92%). No association between recurrence predicted by PET and biological biomarkers was found. Median specific survival appears shorter in patients with metastatic recurrence versus patients with local or no recurrence on PET/CT (p = 0.067). Conclusions: FDG-PET/CT is an effective and reliable tool for the detection of invasive lobular carcinoma recurrence, although certain recurrence sites specific to this histological type can impair its diagnostic performance.
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spelling pubmed-101448462023-04-29 Performance of [18F]FDG-PET/CT Imaging in First Recurrence of Invasive Lobular Carcinoma Bonnin, David Ladoire, Sylvain Briot, Nathalie Bertaut, Aurélie Drouet, Clément Cochet, Alexandre Alberini, Jean-Louis J Clin Med Article Background: Invasive lobular carcinoma accounts for 10 to 15% of all breast cancers. The first objective of this retrospective study was to assess the diagnostic performance of FDG-PET/CT scanning in women previously treated for invasive lobular carcinoma with suspected first recurrence. The secondary objectives were to evaluate the impact of PET/CT in a change in treatment and its prognostic value on specific survival. Methods: Patients in whom a PET/CT scan was performed from January 2011 to July 2019 in our Cancer Research Center were enrolled. Recurrence was suspected based on clinical symptoms, abnormal findings on conventional imaging, and/or elevated tumor markers. The diagnosis of recurrence was established by the oncologist after integration of all clinical, biological, histological, imaging, and follow-up data. Prognostic factors of recurrence as predicted by PET were determined using univariate logistic regression. KI67, mitotic index, or grade of mitosis were tested. Survival curves were compared using the log-rank test. Sixty-four patients (mean age: 60.3; SD = 12.4 years) were enrolled. The average time from initial diagnosis of the primary tumor to suspicion of recurrence was 5.2 ± 4.1 years. Forty-eight patients (75%) were judged to have recurrence by the oncologist: 7 local and 41 metastatic, with mainly bone (n = 24), lymph node (n = 14) and liver (n = 10) metastases. Results: Sensitivity, specificity, and positive and negative predictive values of PET/CT to predict recurrence were, respectively: 87%, 87%, 95%, and 70%. SUVmax at recurrence sites was generally high (mean: 6.4; SD = 2.9). False negative PET/CT results occurred with local (n = 2), peritoneal (n = 2), meningeal (n = 1), or bladder (n = 1) recurrences. In 40 patients with available histopathological data from suspected sites of recurrence, 30 PET/CT were true positive. In four patients, primary lung (n = 1) or gastric (n = 1) tumors or lymphomas (n = 2) were found. The detection of a recurrence resulted in a change in treatment in 44/48 patients (92%). No association between recurrence predicted by PET and biological biomarkers was found. Median specific survival appears shorter in patients with metastatic recurrence versus patients with local or no recurrence on PET/CT (p = 0.067). Conclusions: FDG-PET/CT is an effective and reliable tool for the detection of invasive lobular carcinoma recurrence, although certain recurrence sites specific to this histological type can impair its diagnostic performance. MDPI 2023-04-17 /pmc/articles/PMC10144846/ /pubmed/37109252 http://dx.doi.org/10.3390/jcm12082916 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bonnin, David
Ladoire, Sylvain
Briot, Nathalie
Bertaut, Aurélie
Drouet, Clément
Cochet, Alexandre
Alberini, Jean-Louis
Performance of [18F]FDG-PET/CT Imaging in First Recurrence of Invasive Lobular Carcinoma
title Performance of [18F]FDG-PET/CT Imaging in First Recurrence of Invasive Lobular Carcinoma
title_full Performance of [18F]FDG-PET/CT Imaging in First Recurrence of Invasive Lobular Carcinoma
title_fullStr Performance of [18F]FDG-PET/CT Imaging in First Recurrence of Invasive Lobular Carcinoma
title_full_unstemmed Performance of [18F]FDG-PET/CT Imaging in First Recurrence of Invasive Lobular Carcinoma
title_short Performance of [18F]FDG-PET/CT Imaging in First Recurrence of Invasive Lobular Carcinoma
title_sort performance of [18f]fdg-pet/ct imaging in first recurrence of invasive lobular carcinoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10144846/
https://www.ncbi.nlm.nih.gov/pubmed/37109252
http://dx.doi.org/10.3390/jcm12082916
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