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Japanese Journal of Clinical Oncology 32:244-247 (2002)
© 2002 Foundation for Promotion of Cancer Research

Clinical Impact of [18F]FDG-PET in Patients with Suspected Recurrent Breast Cancer Based on Asymptomatically Elevated Tumor Marker Serum Levels: a Preliminary Report

Chiu-Shong Liu1, Yeh-You Shen2, Cheng-Chieh Lin1, Ruoh-Fang Yen3 and Chia-Hung Kao4,+,§

Departments of 1 Family Medicine and 4 Nuclear Medicine, China Medical College Hospital, Taichung, 2 Department of Nuclear Medicine and PET Center, Shin Kong Wu Ho-Su Memorial Hospital, Taipei and 3 Department of Nuclear Medicine and PET Center, National Taiwan University Hospital, Taipei, Taiwan

Objective: To evaluate retrospectively the impact of [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) on the detection of recurrent breast cancer based on asymptomatically elevated tumor markers levels.

Methods: Whole-body FDG-PET was performed in 30 patients with suspected recurrent breast cancer and asymptomatic tumor marker increase but negative or equivocal other imaging modality results. A blood sample was drawn in each case for marker assay (CA 15-3 and CEA) on the same day as the FDG-PET. All of these 30 asymptomatic patients had either CA l5-3 >32 U/ml or CEA >5 ng/ml. The final diagnosis of recurrent breast cancer was established by operation/biopsy histopathological findings or clinical follow-up for >1 year by additional morphological imaging techniques.

Results: Among the 30 patients, the final diagnosis of recurrent breast cancer was established in 38 sites in 28 patients. FDG-PET accurately detected 35/38 sites in 25/28 patients with recurrence. The diagnostic sensitivity and accuracy of FDG-PET in patients with suspected recurrent breast cancer and asymptomatically elevated tumor markers were 96 and 90%, respectively.

Conclusions: FDG-PET is a useful technique for detecting recurrent breast cancer suspected from asymptomatically elevated tumor markers levels and has an important clinical impact on the management of these patients.

+ For reprints and all correspondence: Chia-Hung Kao, Department of Nuclear Medicine and PET Center, China Medical College Hospital, 2 Yuh-Der Road, Taichung 404, Taiwan. E-mail: d10040@hpd.cmch.org.tw

§ Abbreviations: FDG-PET, [18F]fluorodeoxyglucose positron emission tomography; CEA, carcinoembryonic antigen; CA 15-3, cancer-antigen 15-3; LN, lymph node


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