Correlation between Histopathological Prognostic Tumor Characteristics and [18F]FDG Uptake in Corresponding Metastases in Newly Diagnosed Metastatic Breast Cancer

Jorianne Boers, Bertha Eisses, Mieke C. Zwager, Jasper J.L. van Geel, Frederike Bensch, Erik F.J. de Vries, Geke A.P. Hospers, Andor W.J.M. Glaudemans, Adrienne H. Brouwers, Martijn A.M. den Dekker, Sjoerd G. Elias, Evelien J.M. Kuip, Carla M.L. van Herpen, Agnes Jager, Astrid A.M. van der Veldt, Daniela E. Oprea-Lager, Elisabeth G.E. de Vries, Bert van der Vegt, Willemien C. Menke-van der Houven van Oordt, Carolina P. Schröder*on behalf of the IMPACT-Metastatic Breast Consortium

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background:

 In metastatic breast cancer (MBC), [18F]fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG-PET/CT) can be used for staging. We evaluated the correlation between BC histopathological characteristics and [18F]FDG uptake in corresponding metastases. 

Patients and Methods: 

Patients with non-rapidly progressive MBC of all subtypes prospectively underwent a baseline histological metastasis biopsy and [18F]FDG-PET. Biopsies were assessed for estrogen, progesterone, and human epidermal growth factor receptor 2 (ER, PR, HER2); Ki-67; and histological subtype. [18F]FDG uptake was expressed as maximum standardized uptake value (SUVmax) and results were expressed as geometric means. 

Results: 

Of 200 patients, 188 had evaluable metastasis biopsies, and 182 of these contained tumor. HER2 positivity and Ki-67 ≥ 20% were correlated with higher [18F]FDG uptake (estimated geometric mean SUVmax 10.0 and 8.8, respectively; p = 0.0064 and p = 0.014). [18F]FDG uptake was lowest in ER-positive/HER2-negative BC and highest in HER2-positive BC (geometric mean SUVmax 6.8 and 10.0, respectively; p = 0.0058). Although [18F]FDG uptake was lower in invasive lobular carcinoma (n = 31) than invasive carcinoma NST (n = 146) (estimated geometric mean SUVmax 5.8 versus 7.8; p = 0.014), the metastasis detection rate was similar. 

Conclusions:

[18F]FDG-PET is a powerful tool to detect metastases, including invasive lobular carcinoma. Although BC histopathological characteristics are related to [18F]FDG uptake, [18F]FDG-PET and biopsy remain complementary in MBC staging (NCT01957332).

Original languageEnglish
Article number416
Number of pages14
JournalDiagnostics
Volume14
Issue number4
DOIs
Publication statusPublished - 14 Feb 2024

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Publisher Copyright: © 2024 by the authors.

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