Preoperative [18]fluorodeoxyglucose-positron emission tomography/computed tomography in early stage breast cancer: Rates of distant metastases

Abstract

AIM

To investigate rates of distant metastases (DM) detected with [18]fluorodeoxyglucose-positron emission tomography/computed tomography (¹⁸FDG-PET/CT) in early stage invasive breast cancer.

METHODS

We searched the English language literature databases of PubMed, EMBASE, ISI Web of Knowledge, Web of Science and Google Scholar, for publications on DM detected in patients who had ¹⁸FDG-PET/CT scans as part of the staging for early stages of breast cancer (stage I and II), prior to or immediately following surgery. Reports published between 2011 and 2017 were considered. The systematic review was conducted according to the PRISMA guidelines.

RESULTS

Among the 18 total studies included in the analysis, the risk of DM ranged from 0% to 8.3% and 0% to 12.9% for stage I and II invasive breast cancer, respectively. Among the patients with clinical stage II, the rate of occult metastases diagnosed by ¹⁸FDG-PET/CT was 7.2% (range, 0%-19.6%) for stage IIA and 15.8% (range, 0%-40.8%) for stage IIB. In young patients (< 40-year-old), ¹⁸FDG-PET/CT demonstrated a higher prevalence of DM at the time of diagnosis for those with aggressive histology (i.e., triple-negative receptors and poorly differentiated grade).

CONCLUSION

Young patients with poorly differentiated tumors and stage IIB triple-negative breast cancer may benefit from ¹⁸FDG-PET/CT at initial staging to detect occult DM prior to surgery.

Keywords: Breast cancer; Early stage; Staging workup; Distant metastases; [18]fluorodeoxyglucose-positron emission tomography/computed tomography scan

Core tip: This systematic review identifies groups of patients with early stage breast cancer who might benefit most from [18]fluorodeoxyglucose-positron emission tomography/computed tomography (commonly known as ¹⁸FDG-PET/CT) scan at initial staging, prior to surgery.