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CC BY-NC-ND 4.0 · World J Nucl Med 2018; 17(04): 275-280
DOI: 10.4103/wjnm.WJNM_84_17
Original Article

Prognostic factors in breast cancer patients evaluated by positron-emission tomography/computed tomography before neoadjuvant chemotherapy

Mark Farrugia
1   Department of Medicine, Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, West Virginia 26505
2   Department of Radiation Oncology, West Virginia University, Morgantown, West Virginia 26505
,
Sinjen Wen
3   Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia 26505
,
Geraldine Jacobson
1   Department of Medicine, Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, West Virginia 26505
2   Department of Radiation Oncology, West Virginia University, Morgantown, West Virginia 26505
,
Mohamad Salkeni
1   Department of Medicine, Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, West Virginia 26505
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Neoadjuvant chemotherapy (NAC) is a significant modality in breast cancer therapy. We sought to characterize prognostic factors in patients scheduled for NAC who had a pretreatment positron-emission tomography paired with diagnostic quality contrast-enhanced computed tomography (CT) (positron-emission tomography/CT [PET/CT]). A total of 118 breast cancer patients were analyzed through chart review who underwent pretreatment PET/CT imaging and received NAC from 2008 to 2014. We collected information on molecular markers, PET/CT, pathologic complete response (pCR), survival, and disease status. Pretreatment standard uptake value (SUV) max of the primary breast tumor showed no relationship to pCR; however, there was a statistically significant relationship with relapse-free survival (RFS) using univariate cox regression (P = 0.03, odds ratio (OR) = 1.06 [1.01–1.12]) with comparable findings observed with overall survival (OS). Multivariate analysis revealed SUV max to be significantly correlated with shortened OS (P = 0.022, OR = 1.08 [1.01–1.16]), with a similar trend reported for RFS. By pathological subtype, this correlation was the strongest within hormone receptor (HR+)/human epidermal growth factor receptor 2 (HER2−) tumors. In addition, Kaplan–Meier estimates demonstrated a significant difference between the RFS of triple-negative tumors and HER2 positive tumors (P = 0.001). Interestingly, within this cohort, multivariate Cox regression analysis showed HER2 positivity to be associated with favorable outcome (P = 0.04, HR = 0.22 [0.05–0.94]). These findings demonstrate a significant association between SUV max of HR+/HER2−− tumors and relapse-free and OS. Furthermore, highlighted here is the favorable survival in the once classically aggressive HER2+ breast cancer subgroup.

Keywords

Breast cancer - human epidermal growth factor receptor 2 - neoadjuvant chemotherapy - positron-emission tomography - prognostic factors - standard uptake value


Publication History

Article published online:
17 May 2022

© 2018. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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