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KMID : 1103720140700020145
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Journal of the Korean Society of Radiology
2014 Volume.70 No. 2 p.145 ~ p.152
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Utility of Second-Look Examinations in the Management of a New Hypermetabolic Lesion Detected by Fluorodeoxyglucose Positron Emission Tomography/CT for Diagnosis of Loco-Regional Recurrence in Patients with Breast Cancer
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Park Jin-Young
Cho Kyu-Ran
Park Eun-Kyung
Seo Bo-Kyoung
Woo Ok-Hee
Song Sung-Eun
Oh Yu-Whan
Bae Jeung-Won
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Abstract
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Purpose: To investigate the clinical significance of a new hypermetabolic lesion detected by fluorodeoxyglucose positron emission tomography/CT (FDG-PET/CT) as well as the utility of second-look examinations to evaluate loco-regional recurrence of breast cancer.
Materials and Methods: Our database revealed 922 breast cancer patients who underwent surgery from January 2008 to July 2011. We included 20 patients with negative findings on routine follow-up but with new hypermetabolic lesions on FDG-PET/CT. All underwent second-look examination [breast ultrasound (US) = 14, chest CT scan = 6]. A total of 17 cases were pathologically verified and 3 were diagnosed with follow-up imaging.
Results: The locations were in the axillae (n = 7), breast (n = 6), chest wall (n = 3), cervical/supraclavicular (n = 3), and internal mammary (n = 1). Of the 20 hypermetabolic lesions, 10 were pathologically confirmed malignancies. Of the 14 patients who had undergone US, 7 had suspicious findings and 5 were confirmed as malignancies. Of a total of 6 patients who had undergone CT scans, 5 had suspicious findings and all turned out to be malignancies. The positive predictive value of the second-look examination was 83.3% (10/12).
Conclusion: Second-look examination and pathologic confirmation should be performed for newly appearing hypermetabolic lesions on FDG-PET/CT in order to exclude loco-regional recurrence in breast cancer patients.
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KEYWORD
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Breast Cancer, Fluorodeoxyglucose Positron Emission Tomography/CT, Recurrence, Second-Look Ultrasound
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