The relationship between CEA and CA 15-3 positivity and metabolic and volumetric 18F-FDG PET/CT parameters in preoperative evaluation of breast cancer

Abstract

OBJECTIVE: We aimed to examine the relationship between tumor marker (Cancer Antigen 15-3 [CA15-3] and Carcinoembryonic Antigen [CEA]) positivity and metabolic (standardized uptake value [SUV]) and volume-based (metabolic tumor volume [MTV] and total lesion glycolysis [TLG]) 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) parameters of the primary tumor and lymph node.

MATERIAL AND METHODS: Our study group consisted of 91 female patients, who underwent PET/CT between January 2018 and December 2019 in our clinic with a diagnosis of breast cancer. These patients had no distant metastasis or supraclavicular and internal mammarian lymph node metastasis. MTV, TLG, and SUVmax values were obtained from the primary breast lesion and axillary lymph nodes.

RESULTS: The mean age of the patients, who participated in the study, was 52,19±14,57, and the median values of the primary tumor MTV, TLG, and total MTV values were found to be statistically significantly higher in those who were CEA positive compared to those who were CEA negative.

The median SUVmax value of the axillary lymph node was found to be statistically significantly higher in those who were CEA positive compared to those who were CEA negative (p: 0.004). There was no statistically significant difference between the other parameters.

CONCLUSION: There was a statistically significant correlation between CEA positivity in preoperative primary breast cancer and primary tumor volume MTV, TLG, and total MTV values, which are volume-based PET parameters. CEA positivity evaluation may indicate increased tumor load in preoperative.