J Breast Cancer.  2009 Sep;12(3):163-169. 10.4048/jbc.2009.12.3.163.

Preoperative Axillary Staging Using 18F-FDG PET/CT and Ultrasonography in Breast Cancer Patients

Affiliations
  • 1Department of Surgery, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea. eschang@cnu.ac.kr

Abstract

PURPOSE
The axillary lymph node status is an important prognostic factor for recurrence and survival of patients who have primary breast cancer. This study determined the accuracy of ultrasonography and 18F-FDG positron emission tomography (PET)/computed tomography (CT) in preoperative staging in axilla in patients with breast cancer.
METHODS
One hundred seventy-one patients with primary breast cancer were recruited from January 2007 to August 2008. All the patients underwent axillary ultrasonography and 18F-FDG PET/CT for the axillary staging before their operation. RESULTS: The overall sensitivity, specificity, and the positive and negative predictive values and the accuracy of axillary ultrasonography for making the diagnosis of axillary metastasis were 73.07%, 84.87%, 67.85%, 87.82%, and 81.28%, respectively. On a visual assessment of 18F-FDG PET/CT, the diagnostic accuracy was 85.38% with 69.23% sensitivity, 92.43% specificity, a positive predictive value of 80.00%, and a negative predictive value of 87.30%. By the combined use axillary ultrasonography and 18F-FDG PET/CT to the axilla, the sensitivity, specificity, the positive and negative predictive values and the diagnostic accuracy were 82.35%, 97.91%, 93.33%, 94.00%, and 93.84%, respectively.
CONCLUSION
The combination of 18F-FDG PET/CT and ultrasonography improves preoperative axillary staging in breast cancer that are often not found if only one imaging modalities are applied.

Keyword

Breast neoplasms; Positron-emission tomography; Ultrasonography
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