The Role of FDG PET/CT to Evaluation of Axillary Lymph Nodes after Neoadjuvant Chemotherapy in Breast Cancer | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2021]

Author(s):

1. Eda Tanrikulu Simsek: Department of Medical Oncology, Haydarpasa Numune Training and Research Hospital,Istanbul,Turkey

2. Ezgi Coban: Department of Medical Oncology, Haydarpasa Numune Training and Research Hospital,Istanbul,Turkey

3. Elif Atag: Department of Medical Oncology, Haydarpasa Numune Training and Research Hospital,Istanbul,Turkey

4. Serkan Gungor: Department of Nuclear Medicine, Medeniyet University Hospital,Istanbul,Turkey

5. Murat Sari: Department of Medical Oncology, Haydarpasa Numune Training and Research Hospital,Istanbul,Turkey

6. Gunay Gurleyik: Department of General Surgery, Haydarpasa Numune Training and Research Hospital,Istanbul,Turkey

Abstract:

Objective: To determine the diagnostic value of breast and axillary maximum standard uptake (SUVmax) values for predicting ypT0 and ypN0 separately. Study Design: A descriptive study. Place and Duration of Study: Department of Medical Oncology, Haydarpasa Numune Training and Research Hospita, l between May 2017 and September 2020. Methodology: Consecutive patients with operated breast cancer (BC) after neoadjuvant chemotherapy (NAC) were evaluated. SUVmax on FDG-PET/CT after NAC at both primary tumour (postSUVmax-T) and axillary lymph nodes (postSUVmax-N) were assessed to predict the ypT0 and the ypN0, respectively. Results: Clinically meaningful correlation was detected between postSUVmax-N with ypN0 in patients with human epidermal receptor-positive (Her2+) and triple-negative (TN) BC (in Her2+ BC: r=0.596, p <0.001, in TN BC: r=0.782, p = 0.001). The postSUVmax-N predicted ypN0 with 90.5% positive predictive value (PPV) and 85.7% negative predictive value (NPV) in patients with Her2+ and TN BC. The postSUVmax-T predicted ypT0 with 87.5% PPV and 100% NPV in patients with TN BC (AUC: 0.938, P <0.01) Conclusion: According to this study's ndings, the FDG-PET/CT may be an alternative to sentinel lymph node biopsy (SNB) to protect patients from axillary lymph node dissection when the expected FNR of the SNB is high in patients with Her+ and TN BC.

Page(s): 792-797

DOI: 10.29271/jcpsp.2021.07.792

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 31, Issue: 07, Year: 2021

Keywords:

Breast Cancer , Neoadjuvant therapy , FDG PETCT

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