Tarik Sengoz1, Yeliz Arman Karakaya2, Aziz Gultekin3, Olga Yaylali4, Hande Senol5, Dogangun Yuksel6. 1. Pamukkale University, Medical Faculty, Department of Nuclear Medicine, Denizli, Turkey. Electronic address: tsengoz@pau.edu.tr. 2. Pamukkale University, Medical Faculty, Department of Pathology, Denizli, Turkey. Electronic address: ykarakaya@pau.edu.tr. 3. Pamukkale University, Medical Faculty, Department of Nuclear Medicine, Denizli, Turkey. Electronic address: agultekin@pau.edu.tr. 4. Pamukkale University, Medical Faculty, Department of Nuclear Medicine, Denizli, Turkey. Electronic address: oyaylali@pau.edu.tr. 5. Pamukkale University, Medical Faculty, Department of Biostatistics, Denizli, Turkey. Electronic address: hsenol@pau.edu.tr. 6. Pamukkale University, Medical Faculty, Department of Nuclear Medicine, Denizli, Turkey. Electronic address: dyuksel@pau.edu.tr.
Abstract
OBJECTIVES: In this study, we aimed to investigate the correlation between SUVmax of primary tumor and prognostic factors/molecular subtype in ductal breast cancer patients. MATERIALS AND METHODS: We retrospectively reviewed 150 female patients with pathologically proven invasive ductal breast cancer from January 2015 to October 2019 who underwent 18F-FDG PET/CT for initial staging. Histopathological prognostic features of the primary tumor (histological grade, hormone receptor status, Ki-67 index, vb.) were obtained from the tru-cut biopsy report. In 18F-FDG PET/CT studies, the maximum standardized uptake value (SUVmax) of the primary breast tumor was calculated and compared with the presence of axillary lymphadenopathy and/or distant metastases, histopathological prognostic factors and molecular subtype. RESULTS: The high SUVmax of primary breast tumors is significantly correlated with the clinicopathological factors: high tumor size, high histologic grade, high Ki-67 index, axillary lymph node positivity and distant metastasis. SUVmax value was significantly higher in patients with basal subtype than patients with Luminal A subtype (8,14 ± 3,71 and 4,64 ± 2,45, p = 0,002). Correlation analysis revealed a low correlation between Ki-67 index and SUVmax (r = 0,276, p = 0,001) and moderate correlation between tumor size and SUVmax (r = 0,470, p = 0,001). In multivariate linear regression analysis, Ki-67 index and tumor size had a statistically significant effect on SUVmax values. As these parameters increase, it is seen that it increases SUVmax values (p = 0,004, Std Beta: 0,228, 95% CI:0,010-0,055 and p = 0,001, Std Beta:0,374, 95% CI:0,55-0,136, respectively). CONCLUSION: High SUVmax value is associated with factors suggesting poor prognosis. Pretreatment 18F-FDG PET/CT can be used as a tool to predict prognosis in breast cancer.
OBJECTIVES: In this study, we aimed to investigate the correlation between SUVmax of primary tumor and prognostic factors/molecular subtype in ductal breast cancer patients. MATERIALS AND METHODS: We retrospectively reviewed 150 female patients with pathologically proven invasive ductal breast cancer from January 2015 to October 2019 who underwent 18F-FDG PET/CT for initial staging. Histopathological prognostic features of the primary tumor (histological grade, hormone receptor status, Ki-67 index, vb.) were obtained from the tru-cut biopsy report. In 18F-FDG PET/CT studies, the maximum standardized uptake value (SUVmax) of the primary breast tumor was calculated and compared with the presence of axillary lymphadenopathy and/or distant metastases, histopathological prognostic factors and molecular subtype. RESULTS: The high SUVmax of primary breast tumors is significantly correlated with the clinicopathological factors: high tumor size, high histologic grade, high Ki-67 index, axillary lymph node positivity and distant metastasis. SUVmax value was significantly higher in patients with basal subtype than patients with Luminal A subtype (8,14 ± 3,71 and 4,64 ± 2,45, p = 0,002). Correlation analysis revealed a low correlation between Ki-67 index and SUVmax (r = 0,276, p = 0,001) and moderate correlation between tumor size and SUVmax (r = 0,470, p = 0,001). In multivariate linear regression analysis, Ki-67 index and tumor size had a statistically significant effect on SUVmax values. As these parameters increase, it is seen that it increases SUVmax values (p = 0,004, Std Beta: 0,228, 95% CI:0,010-0,055 and p = 0,001, Std Beta:0,374, 95% CI:0,55-0,136, respectively). CONCLUSION: High SUVmax value is associated with factors suggesting poor prognosis. Pretreatment 18F-FDG PET/CT can be used as a tool to predict prognosis in breast cancer.