PET imaging of oestrogen receptors in patients with breast cancer

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Abstract

Oestrogen receptors are overexpressed in around 70% of all breast cancers, and are a target for endocrine therapy. These receptors can be visualised on PET with use of 16 alpha-[F-18]-fluoro-17 beta-oestradiol (F-18-FES) as a tracer. Compared with biopsy, which enables assessment of individual sites, whole-body F-18-FES-PET enables quantification of oestrogen-receptor expression in all metastases. In several studies, measurement of tumour protein expression in oestrogen receptors by F-18-FES-PET, concurrent with biopsy, detected oestrogen-receptor-positive tumour lesions with a sensitivity of 84% and specificity of 98%. Roughly 45% of patients with metastatic breast cancer have discordant oestrogen-receptor expression across lesions (ie, F-18-FES-positive and F-18-FES-negative metastases). Low tumour F-18-FES uptake in metastases can predict failure of hormonal therapy in patients with oestrogen-receptor-positive primary tumours. Finally, F-18-FES-PET has shown that oestrogen-receptor binding capacity changes after intervention with hormonal drugs, but findings need to be confirmed. Factors other than oestrogen-receptor expression, including menopausal status and concomitant therapies, that can affect tumour F-18-FES uptake must be taken into account.

Original languageEnglish
Pages (from-to)E465-E475
Number of pages11
JournalLancet Oncology
Volume14
Issue number11
Publication statusPublished - Oct-2013

Keywords

  • POSITRON-EMISSION-TOMOGRAPHY
  • HORMONE-BINDING GLOBULIN
  • IN-VIVO
  • FLUORINE-18-LABELED ESTROGENS
  • IMMUNOHISTOCHEMICAL ANALYSIS
  • METABOLIC FLARE
  • UTERINE-TUMORS
  • FES PET
  • TAMOXIFEN
  • ALPHA

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