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Positron Emission Tomography Proves Best for Finding Recurrent Breast Cancer

RESTON, VA — March 7, 2002 — Positron emission tomography (PET imaging) can reassure previously treated women that they are breast cancer free, and can better predict if their disease is likely to recur than other types of diagnostic imaging, according to researchers.

The study, published in the March issue of The Journal of Nuclear Medicine, compared the outcomes of 61 women previously treated for breast cancer. The women received both 18F-FDG PET and conventional imaging (CI), and were followed-up for at least six months to determine how, or if, their disease progressed. Conventional imaging techniques include x-ray, computed tomography (CT), sonography, magnetic resonance imaging (MRI), mammography, and bone scans.

Significantly, all six women with positive CI results but whose PET scans were negative were free of disease at last follow-up. In the nine women with negative CI but positive PET results, six were later found to have recurrent disease and received additional treatment. Overall, PET and CI findings differed in a quarter of the women; PET correctly predicted the outcome in 80 percent of these cases versus 20 percent for CI.

PET was also better at determining the length of disease-free survival, with 90 percent accuracy versus 75 percent for CI. Women with positive results for both PET and CI showed similar periods of survival; however, women with negative PET results had significantly longer disease-free survival than those with negative CI results. Overall, PET demonstrated better sensitivity (93 percent versus 79 percent) and specificity (84 percent versus 68 percent) than CI.

The authors point out that early detection of local recurrence and metastatic disease can impact therapy. For example, local recurrence and axillary lymph node involvement may be treated surgically or with radiation, whereas mediastinal lymph node involvement or distant metastases typically require chemotherapy. The six women with true-positive PET results and false-negative CI were able to receive treatment for their recurrence, such as additional chemotherapy, radiation, and surgery.

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