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Annals of Oncology 2007 18(8):1329-1334; doi:10.1093/annonc/mdm139
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© 2007 European Society for Medical Oncology

breast cancer

Therapeutic impact of 2-[fluorine-18]fluoro-2-deoxy-D-glucose positron emission tomography in the pre- and postoperative staging of patients with clinically intermediate or high-risk breast cancer

B Klaeser1,4,*, O Wiederkehr2, D Koeberle3, A Mueller2,3, B Bubeck1 and B Thuerlimann2,3

1 Department of Nuclear Medicine
2 Senology Center of Eastern Switzerland
3 Department of Internal Medicine, Division Oncology-Hematology, Kantonsspital, St Gallen
4 Department of Nuclear Medicine, Inselspital, Bern, Switzerland

* Correspondence to: Dr B. Klaeser, Klinik und Poliklinik für Nuklearmedizin, Inselspital, 3010 Bern, Switzerland. Tel: +41-31-6323655; Fax: +41-31-6323137; E-mail: bernd.klaeser{at}insel.ch

Background: Positron emission tomography with 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG–PET) is an accurate imaging modality for the staging of breast cancer. The aim of this study was to determine the potential therapeutic impact of pre- and postoperative FDG–PET in patients with clinically intermediate or high-risk breast cancer.

Patients and methods: One hundred and fourteen patients with newly diagnosed breast cancer were examined before (73) or after (41) surgery. Patient data were translated into three scoring sheets corresponding to information available before positron emission tomography (PET), after PET and after further diagnostic tests. Three medical oncologists independently reviewed the retrospectively acquired patient data and prospectively made decisions on the theoretically planed treatment for each time point, according to the recommendations of St Gallen Consensus Guidelines 2005.

Results: FDG–PET changed the planed treatment in 32% of 114 patients. In 20% of cases, therapeutic intention (curative versus palliative) was modified. Radiation treatment planning was changed in 27%, surgical planning in 9%, chemotherapy in 11% and intended therapy with bisphosphonates in 13% of all patients.

Conclusion: Based on current treatment guidelines, FDG–PET, as a staging procedure in patients with newly diagnosed clinically intermediate or high-risk breast cancer examined pre- and postoperatively, may have a substantial therapeutic impact on treatment planning.

Key words: breast cancer, FDG, patient management, positron emission tomography, primary staging, therapeutic impact

Received for publication December 20, 2006. Revision received March 25, 2007. Accepted for publication March 26, 2007.


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