Nursal Gül Nihal, Nursal Tarik Zafer, Aytac Huseyin Ozgur, Hasbay Bermal, Torun Neşe, Reyhan Mehmet, Yapar Ali Fuat
From the Departments of *Nuclear Medicine, †General Surgery, and ‡Pathology, Baskent University Adana Teaching and Research Center, Adana, Turkey.
Clin Nucl Med. 2016 May;41(5):362-5. doi: 10.1097/RLU.0000000000001165.
Advanced imaging methods in early breast cancers are not recommended before surgery. In contrast to the accepted guidelines, some recent studies have shown some benefits with the use of PET/CT in early-stage breast cancer. In this study, we aimed to document the efficacy of PET/CT in detection of distant metastasis as well as other primary cancers.
In this retrospective study, we reviewed the records of all women patients diagnosed with early breast cancer between March 2012 and December 2014. Besides demographics, we recorded the clinical TNM stage, histology of the tumor, and hormone receptor status. As PET/CT imaging is a routine procedure in our center for early breast cancer, tumor size, lymph node status, distant metastasis, and possible other primary malignancies detected by PET/CT were also recorded.
Of the 419 women included in the study, 24.8% were clinically staged as stage I while the rest were stage II. Distant metastases were detected in 42 patients (10%). The yield of PET/CT in detecting metastasis was significant in stage II patients compared with stage I patients (12.4% vs 2.9%). In subgroup analysis of stage II patients, the performance of PET/CT in detecting metastasis was still evident in stage IIA patients (9.5%). In logistic regression analysis of the significant and near-significant factors (as detected by univariate analysis) effecting PET/CT detected distant metastasis, only nodal status (P = 0.053) was found to be significant.
We suggest the use of PET/CT in investigating metastasis in axilla positive and clinically stage II early breast cancer patients.
不建议在早期乳腺癌手术前使用先进的成像方法。与公认的指南相反，一些近期研究显示在早期乳腺癌中使用PET/CT有一定益处。在本研究中，我们旨在记录PET/CT在检测远处转移以及其他原发性癌症方面的疗效。
在这项回顾性研究中，我们查阅了2012年3月至2014年12月期间所有被诊断为早期乳腺癌的女性患者的记录。除了人口统计学信息外，我们记录了临床TNM分期、肿瘤组织学类型以及激素受体状态。由于PET/CT成像在我们中心是早期乳腺癌的常规检查项目，因此还记录了PET/CT检测到的肿瘤大小、淋巴结状态、远处转移以及可能的其他原发性恶性肿瘤。
在纳入研究的419名女性中，24.8%临床分期为I期，其余为II期。42名患者（10%）检测到远处转移。与I期患者相比，PET/CT在检测II期患者转移方面的检出率更高（12.4%对2.9%）。在II期患者的亚组分析中，PET/CT在检测IIA期患者转移方面的表现仍然明显（9.5%）。在对影响PET/CT检测远处转移的显著和接近显著因素（通过单因素分析检测）进行逻辑回归分析时，仅发现淋巴结状态（P = 0.053）具有显著性。
我们建议对腋窝阳性且临床分期为II期的早期乳腺癌患者使用PET/CT来研究转移情况。
