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

IMPACT-Metastatic Breast Consortium, 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 OordtCarolina P Schröder*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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 (SUV max) 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 SUV max 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 SUV max 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 SUV max 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 pages15
Issue number4
Publication statusPublished - 14-Feb-2024

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