Positron emission tomography/computed tomography in the management of recurrent/metastatic breast cancer: a large retrospective study from the Royal Marsden Hospital — Ann Oncol

Positron emission tomography/computed tomography in the management of recurrent/metastatic breast cancer: a large retrospective study from the Royal Marsden Hospital
A. Constantinidou1,*, A. Martin2, B. Sharma2 and S. R. D. Johnston1

+ Author Affiliations
1Department of Medical Oncology, Breast Unit
2Department of Radiology, The Royal Marsden Hospital, London, UK

Ann Oncol (2011) 22 (2): 307-314.
doi: 10.1093/annonc/mdq343
First published online: July 12, 2010


*Correspondence to: Dr A. Constantinidou, Department of Medical Oncology, Breast Unit, The Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK. Tel: +44-207-8082748; Fax: +44-207-8082563; E-mail: Anastasia.Constantinidou@rmh.nhs.uk; Anastasia.Constantinidou@icr.ac.uk

Received January 30, 2010.
Revision received May 4, 2010.
Accepted May 7, 2010.


Abstract
Background: Despite the increasing use of positron emission tomography/computed tomography (PET/CT) in the management of patients with breast cancer, its role is yet to be defined.
Patients and methods: We reviewed PET/CT scans carried out in breast cancer patients, the indication, concordance/discordance with other imaging and whether their use had altered patient management.

Results: PET/CT scans (233) were carried out in 122 patients between July 2004 and October 2008. Indications were as follows: staging (S) (91), response assessment (RA) (87), clarification (C) of findings on other imaging (32) and reassurance (ASS) (23). In the S group, positive scans were helpful in accurately defining the extent of disease and guided localised or systemic treatment. PET/CT was particularly useful for detecting lytic bone metastases. One-third of the scans was carried out for RA. PET/CT allowed early RA and in some cases appropriate discontinuation of ineffective treatment. PET/CT was used effectively for the clarification of indeterminate lesions on CT (18), magnetic resonance imaging (15) and bone scan (13). In the ASS group, all scans were negative.

Conclusions: PET/CT is useful in accurately staging metastatic disease, assessing response to systemic treatment and clarifying equivocation on other imaging. Incorporation of PET/CT in these areas contributes to breast cancer management optimisation.


Positron emission tomography/computed tomography in the management of recurrent/metastatic breast cancer: a large retrospective study from the Royal Marsden Hospital — Ann Oncol