The effect of preoperative 18f Fdg-Pet on staging and treatment protocols in breast cancer patients

Abstract

AIM: We aimed to evaluate the effect of PET taken before surgery on the treatment protocol in patients diagnosed with BC and whether PET resulted in changes in the disease stage.

MATERIAL AND METHODS: BC patients in our hospital who underwent surgery between 2016–2020 were retrospectively analyzed. The effect of preoperative PET on the treatment protocol was evaluated in all. Patients were divided into subgroups depending on whether they underwent direct surgery without CTX or were operated on after CTX initiation.

In addition, in the group that did not receive CTX, axillary findings of PET were compared with postoperative histopathological results, and axillary PPV, NPV, sensitivity and specificity of PET were determined. In this subgroup, the preoperative PET stage was compared with the postoperative histopathological stage, and any changes in the disease stage were compared.

RESULTS: In our study, PET affected the treatment protocol of 19 patients (20%). PET resulted in staging differences in 57.6% overall, increased staging in four patients (8.8%) who did not receive early-stage CT, and lower staging in 22 (48.8%) patients in the group. In early-stage BC of PET, the PPV for axilla was 81.2%, the NPV was 65.5%, sensitivity was 56.5%, and specificity was 86.3%.

DISCUSSION: Although PET has many limitations, the determination of the size of the primary tumor and the multiple foci at different locations according to PET findings helped us to easily determine the treatment protocol for patients planned for BCS.

CONCLUSION: The preoperative routine use of PET, which can provide more information about metastasis and stage than other methods in patients undergoing BC surgery, may improve the management of treatment in these patients.