PURPOSE: The aim of this prospective study was to assess the incidence of extra-axillary lymph node involvement on baseline FDG PET/CT in patients with stage II-III breast cancer scheduled for neo-adjuvant chemotherapy. METHODS: Patients with invasive breast cancer of >3 cm and/or proven axillary lymph node metastasis were included for before neo-adjuvant chemotherapy. Baseline ultrasound of the infra- and supraclavicular regions was performed with fine-needle biopsy as needed. Subsequently FDG PET/CT was performed. All visually FDG-positive nodes were regarded as metastatic based on the previously reported high specificity of the technique. RESULTS: Sixty patients were included. In 17 patients (28%) extra-axillary lymph nodes were detected by FDG PET/CT, localised in an intra-mammary node (1 lymph node in 1 patient), mediastinal (2 lymph nodes in 2 patients), internal mammary chain (9 lymph nodes in 8 patients), intra- and interpectoral (6 lymph nodes in 4 patients), infraclavicular (5 lymph nodes in 4 patients) and in the contralateral axilla (3 lymph nodes in 2 patients). Ultrasound-guided cytology had detected extra-axillary lymph node involvement in seven of these patients, but was unable to detect extra-axillary nodes in the other 10 patients with positive extra-axillary lymph nodes on FDG PET/CT. Radiotherapy treatment was altered in 7 patients with extra-axillary involvement (12% of the total group). CONCLUSIONS: FDG PET/CT detected extra-axillary lymph node involvement in almost one-third of the patients with stage II-III breast cancer, including regions not evaluable with ultrasound. FDG PET/CT may be useful as an additional imaging tool to assess extra-axillary lymph node metastasis, with an impact on the adjuvant radiotherapy management.
PURPOSE: The aim of this prospective study was to assess the incidence of extra-axillary lymph node involvement on baseline FDG PET/CT in patients with stage II-III breast cancer scheduled for neo-adjuvant chemotherapy. METHODS:Patients with invasive breast cancer of >3 cm and/or proven axillary lymph node metastasis were included for before neo-adjuvant chemotherapy. Baseline ultrasound of the infra- and supraclavicular regions was performed with fine-needle biopsy as needed. Subsequently FDG PET/CT was performed. All visually FDG-positive nodes were regarded as metastatic based on the previously reported high specificity of the technique. RESULTS: Sixty patients were included. In 17 patients (28%) extra-axillary lymph nodes were detected by FDG PET/CT, localised in an intra-mammary node (1 lymph node in 1 patient), mediastinal (2 lymph nodes in 2 patients), internal mammary chain (9 lymph nodes in 8 patients), intra- and interpectoral (6 lymph nodes in 4 patients), infraclavicular (5 lymph nodes in 4 patients) and in the contralateral axilla (3 lymph nodes in 2 patients). Ultrasound-guided cytology had detected extra-axillary lymph node involvement in seven of these patients, but was unable to detect extra-axillary nodes in the other 10 patients with positive extra-axillary lymph nodes on FDG PET/CT. Radiotherapy treatment was altered in 7 patients with extra-axillary involvement (12% of the total group). CONCLUSIONS: FDG PET/CT detected extra-axillary lymph node involvement in almost one-third of the patients with stage II-III breast cancer, including regions not evaluable with ultrasound. FDG PET/CT may be useful as an additional imaging tool to assess extra-axillary lymph node metastasis, with an impact on the adjuvant radiotherapy management.
Authors: Maxine S Jochelson; Lizza Lebron; Stefanie S Jacobs; Junting Zheng; Chaya S Moskowitz; Simon N Powell; Virgilio Sacchini; Gary A Ulaner; Elizabeth A Morris; D David Dershaw Journal: AJR Am J Roentgenol Date: 2015-10 Impact factor: 3.959
Authors: B B Koolen; M J T F D Vrancken Peeters; J Wesseling; E H Lips; W V Vogel; T S Aukema; E van Werkhoven; K G A Gilhuijs; S Rodenhuis; E J Th Rutgers; R A Valdés Olmos Journal: Eur J Nucl Med Mol Imaging Date: 2012-08-16 Impact factor: 9.236
Authors: Briete Goorts; Stefan Vöö; Thiemo J A van Nijnatten; Loes F S Kooreman; Maaike de Boer; Kristien B M I Keymeulen; Romy Aarnoutse; Joachim E Wildberger; Felix M Mottaghy; Marc B I Lobbes; Marjolein L Smidt Journal: Eur J Nucl Med Mol Imaging Date: 2017-06-10 Impact factor: 9.236
Authors: Min Jung Seo; Jong Jin Lee; Hye Ok Kim; Sun-Young Chae; Seol Hoon Park; Jin-Sook Ryu; Sei Hyun Ahn; Jong Won Lee; Byung Ho Son; Gyung-Yub Gong; Dae Hyuk Moon Journal: Eur J Nucl Med Mol Imaging Date: 2013-11-06 Impact factor: 9.236
Authors: Christopher C Riedl; Elina Slobod; Maxine Jochelson; Monica Morrow; Debra A Goldman; Mithat Gonen; Wolfgang A Weber; Gary A Ulaner Journal: J Nucl Med Date: 2014-09-11 Impact factor: 10.057