18F-2-fluoro-2-deoxy-D-glucose positron emission tomography in staging of locally advanced breast cancer

Jacobus J M Van Der Hoeven, Nanda C. Krak, Otto S. Hoekstra, Emile F I Comans, Robert P A Boom, Dick Van Geldere, Sybren Meijer, Elsken Van Der Wall, Jan Buter, Herbert M. Pinedo, Gerrit J J Teule, Adriaan A. Lammertsma

Research output: Contribution to journalArticle

Abstract

Purpose: To prospectively evaluate the effect of adding whole-body 18F-2-fluoro-2-deoxy-o-glucose (FDG) positron emission tomography (PET) to conventional screening for distant metastases in patients with locally advanced breast cancer (LABC). Patients and Methods: All women with LABC referred for participation in the LABC Spinoza trial were considered eligible for this study. Patients were included if chest x-ray, bone scan, liver ultrasound, or computed tomography scan performed by the referring physician failed to reveal distant metastases. They underwent whole-body FDG PET scanning before therapy. Patients with subsequently proven distant metastases were switched to alternative forms of chemotherapy, hormonal therapy, or both. Results: Among the 48 patients evaluated with PET, 14 had abnormal FDG uptake, and metastases were suspected in 12. After simple clinical evaluation (plain x-ray, history), 10 sites that were suggestive of abnormality remained. Further work-up revealed that four sites were metastases. Proven false positivity occurred in one patient with sarcoidosis. In the other five patients, the reason for abnormal FDG uptake (liver, lung, bone) remained unclear, and patients were treated as planned. Eleven months later, distant metastases were found in one patient at sites unrelated to the previous FDG uptake. Conclusion: The addition of FDG PET to the standard work-up of patients with LABC may lead to the detection of unexpected distant metastases. This may contribute to a more realistic stratification between patients with true stage III breast cancer and those who are in fact suffering from stage IV disease. Abnormal PET findings should be confirmed to prevent patients from being denied appropriate treatment.

Original languageEnglish (US)
Pages (from-to)1253-1259
Number of pages7
JournalJournal of Clinical Oncology
Volume22
Issue number7
DOIs
StatePublished - 2004
Externally publishedYes

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Fluorodeoxyglucose F18
Positron-Emission Tomography
Breast Neoplasms
Neoplasm Metastasis
Glucose
X-Rays
Bone and Bones
Liver
Sarcoidosis
Thorax
Therapeutics
History
Tomography
Physicians

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Van Der Hoeven, J. J. M., Krak, N. C., Hoekstra, O. S., Comans, E. F. I., Boom, R. P. A., Van Geldere, D., ... Lammertsma, A. A. (2004). 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography in staging of locally advanced breast cancer. Journal of Clinical Oncology, 22(7), 1253-1259. https://doi.org/10.1200/JCO.2004.07.058

18F-2-fluoro-2-deoxy-D-glucose positron emission tomography in staging of locally advanced breast cancer. / Van Der Hoeven, Jacobus J M; Krak, Nanda C.; Hoekstra, Otto S.; Comans, Emile F I; Boom, Robert P A; Van Geldere, Dick; Meijer, Sybren; Van Der Wall, Elsken; Buter, Jan; Pinedo, Herbert M.; Teule, Gerrit J J; Lammertsma, Adriaan A.

In: Journal of Clinical Oncology, Vol. 22, No. 7, 2004, p. 1253-1259.

Research output: Contribution to journalArticle

Van Der Hoeven, JJM, Krak, NC, Hoekstra, OS, Comans, EFI, Boom, RPA, Van Geldere, D, Meijer, S, Van Der Wall, E, Buter, J, Pinedo, HM, Teule, GJJ & Lammertsma, AA 2004, '18F-2-fluoro-2-deoxy-D-glucose positron emission tomography in staging of locally advanced breast cancer', Journal of Clinical Oncology, vol. 22, no. 7, pp. 1253-1259. https://doi.org/10.1200/JCO.2004.07.058
Van Der Hoeven, Jacobus J M ; Krak, Nanda C. ; Hoekstra, Otto S. ; Comans, Emile F I ; Boom, Robert P A ; Van Geldere, Dick ; Meijer, Sybren ; Van Der Wall, Elsken ; Buter, Jan ; Pinedo, Herbert M. ; Teule, Gerrit J J ; Lammertsma, Adriaan A. / 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography in staging of locally advanced breast cancer. In: Journal of Clinical Oncology. 2004 ; Vol. 22, No. 7. pp. 1253-1259.
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abstract = "Purpose: To prospectively evaluate the effect of adding whole-body 18F-2-fluoro-2-deoxy-o-glucose (FDG) positron emission tomography (PET) to conventional screening for distant metastases in patients with locally advanced breast cancer (LABC). Patients and Methods: All women with LABC referred for participation in the LABC Spinoza trial were considered eligible for this study. Patients were included if chest x-ray, bone scan, liver ultrasound, or computed tomography scan performed by the referring physician failed to reveal distant metastases. They underwent whole-body FDG PET scanning before therapy. Patients with subsequently proven distant metastases were switched to alternative forms of chemotherapy, hormonal therapy, or both. Results: Among the 48 patients evaluated with PET, 14 had abnormal FDG uptake, and metastases were suspected in 12. After simple clinical evaluation (plain x-ray, history), 10 sites that were suggestive of abnormality remained. Further work-up revealed that four sites were metastases. Proven false positivity occurred in one patient with sarcoidosis. In the other five patients, the reason for abnormal FDG uptake (liver, lung, bone) remained unclear, and patients were treated as planned. Eleven months later, distant metastases were found in one patient at sites unrelated to the previous FDG uptake. Conclusion: The addition of FDG PET to the standard work-up of patients with LABC may lead to the detection of unexpected distant metastases. This may contribute to a more realistic stratification between patients with true stage III breast cancer and those who are in fact suffering from stage IV disease. Abnormal PET findings should be confirmed to prevent patients from being denied appropriate treatment.",
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AU - Krak, Nanda C.

AU - Hoekstra, Otto S.

AU - Comans, Emile F I

AU - Boom, Robert P A

AU - Van Geldere, Dick

AU - Meijer, Sybren

AU - Van Der Wall, Elsken

AU - Buter, Jan

AU - Pinedo, Herbert M.

AU - Teule, Gerrit J J

AU - Lammertsma, Adriaan A.

PY - 2004

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N2 - Purpose: To prospectively evaluate the effect of adding whole-body 18F-2-fluoro-2-deoxy-o-glucose (FDG) positron emission tomography (PET) to conventional screening for distant metastases in patients with locally advanced breast cancer (LABC). Patients and Methods: All women with LABC referred for participation in the LABC Spinoza trial were considered eligible for this study. Patients were included if chest x-ray, bone scan, liver ultrasound, or computed tomography scan performed by the referring physician failed to reveal distant metastases. They underwent whole-body FDG PET scanning before therapy. Patients with subsequently proven distant metastases were switched to alternative forms of chemotherapy, hormonal therapy, or both. Results: Among the 48 patients evaluated with PET, 14 had abnormal FDG uptake, and metastases were suspected in 12. After simple clinical evaluation (plain x-ray, history), 10 sites that were suggestive of abnormality remained. Further work-up revealed that four sites were metastases. Proven false positivity occurred in one patient with sarcoidosis. In the other five patients, the reason for abnormal FDG uptake (liver, lung, bone) remained unclear, and patients were treated as planned. Eleven months later, distant metastases were found in one patient at sites unrelated to the previous FDG uptake. Conclusion: The addition of FDG PET to the standard work-up of patients with LABC may lead to the detection of unexpected distant metastases. This may contribute to a more realistic stratification between patients with true stage III breast cancer and those who are in fact suffering from stage IV disease. Abnormal PET findings should be confirmed to prevent patients from being denied appropriate treatment.

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