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Detection of isolated ipsilateral regional lymph node recurrences by F18-fluorodeoxyglucose positron emission tomography–CT in follow-up of postoperative breast cancer patients

  • Epidemiology
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Abstract

Imaging diagnostic methods except for mammograms are not recommended for follow-up of postoperative breast cancer patients in order to detect small recurrences because of the poor survival improvement in earlier randomized trials. However, the use of new imaging modalities may improve survival by detection of small isolated regional lymph node recurrences which are potentially curable. Between April 2006 and December 2008, we used PET–CT to find small recurrences in follow-up of 1,907 postoperative breast cancer patients. A total of 3,280 PET–CT imagings were performed. The median age at PET–CT imaging was 58 years, with a median 48-month interval from definitive surgery to the PET–CT imaging. Twenty-two patients were found to have isolated ipsilateral regional recurrences only by PET–CT (axillary node recurrences in 6, infraclavicular node recurrences in 5, supraclavicular node recurrences in 6, and parasternal node recurrences in 5). All of those recurrences were missed by palpation or were nonpalpable. The pathological lymph node status at the definitive surgery for the primary breast cancer of 22 patients with the isolated ipsilateral regional lymph node recurrences was positive in 17 patients. If patients are limited to those who had pathologically positive node(s) at definitive surgery, the incidence of patients with isolated regional lymph node recurrences found only by PET–CT would be 2.6% (17/663 patients). Seventeen other asymptomatic cancers including contralateral breast cancers were found only by PET–CT. Early detection of isolated loco-regional recurrences of breast cancer is suggested to result in improved survival. Therefore, the use of PET–CT in follow-up of postoperative node-positive breast cancer patients may improve their survival because of early detection of isolated regional lymph node recurrences which are still potentially curable, and screening of other asymptomatic cancers.

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References

  1. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomized trials. Lancet 365(9472):1687–1717

    Article  Google Scholar 

  2. Greenberg PA, Hortobagyi GN, Smith TL, Ziegler LD, Frye DK, Buzdar AU (1996) Long-term follow-up of patients with complete remission following combination chemotherapy for metastatic breast cancer. J Clin Oncol 14(8):2197–2205

    PubMed  CAS  Google Scholar 

  3. The GIVIO Investigators (1994) Impact of follow-up testing on survival and health-related quality of life in breast cancer patients. A multicenter randomized controlled trial. JAMA 271(20):1587–1592

    Article  Google Scholar 

  4. Rosselli Del Turco M, Palli D, Cariddi A, Ciatto S, Pacini P, Distante V (1994) Intensive diagnostic follow-up after treatment of primary breast cancer. A randomized trial. National Research Council Project on Breast Cancer follow-up. JAMA 271(20):1593–1597

    Article  PubMed  CAS  Google Scholar 

  5. Khatcheressian JL, Wolff AC, Smith TJ, Grunfeld E, Muss HB, Vogel VG, Halberg F, Somerfield MR, Davidson NE (2006) American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting. J Clin Oncol 24(31):5091–5097

    Article  PubMed  Google Scholar 

  6. Veronesi U, Arnone P, Veronesi P, Galimberti V, Luini A, Rotmensz N, Botteri E, Ivaldi GB, Leonardi MC, Viale G, Sagona A, Paganelli G, Panzeri R, Orecchia R (2008) The value of radiotherapy on metastatic internal mammary nodes in breast cancer. Results on a large series. Ann Oncol 19(9):1553–1560

    Article  PubMed  CAS  Google Scholar 

  7. Brito RA, Valero V, Buzdar AU, Booser DJ, Ames F, Strom E, Ross M, Theriault RL, Frye D, Kau S-W, Asmar L, McNeese M, Singletary SE, Hortobagyi GN (2001) Long-term results of combined-modality therapy for locally advanced breast cancer with ipsilateral supraclavicular metastases: the University of Texas M.D. Anderson Cancer Center Experience. J Clin Oncol 19(3):628–633

    PubMed  CAS  Google Scholar 

  8. Olivotto IA, Chua B, Allan SJ, Speers CH, Chia S, Ragaz J (2003) Long-term survival of patients with supraclavicular metastases at diagnosis of breast cancer. J Clin Oncol 21(5):851–854

    Article  PubMed  Google Scholar 

  9. Recht A, Edge SB, Solin LJ, Robinson DS, Estabrook A, Fine RE, Fleming GF, Formenti S, Hudis C, Kirshner JJ, Krause DA, Kuske RR, Langer AS, Sledge GW Jr, Whelan TJ, Pfister DG (2001) Postmastectomy radiotherapy: clinical practice guidelines of the American society of clinical oncology. J Clin Oncol 19(5):1539–1569

    PubMed  CAS  Google Scholar 

  10. Sobin L, Gospodarowicz M, Wittekind C (2010) Classification of malignant tumours, 7th edn. Wiley-Blackwell, Oxford

    Google Scholar 

  11. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (2010) Cancer staging manual, 7th edn. Springer, New York

    Google Scholar 

  12. Hodgson NC, Gulenchyn KY (2008) Is there a role for positron emission tomography in breast cancer staging? J Clin Oncol 26(5):712–720

    Article  PubMed  Google Scholar 

  13. Escalona S, Blasco JA, Reza MM, Andradas E, Gomez N (2010) A systematic review of FDG-PET in breast cancer. Med Oncol 27(1):114–129

    Article  PubMed  CAS  Google Scholar 

  14. Isasi CR, Moadel RM, Blaufox MD (2005) A meta-analysis of FDG-PET for the evaluation of breast cancer recurrence and metastases. Breast Cancer Res Treat 90(2):105–112

    Article  PubMed  CAS  Google Scholar 

  15. Piperkova E, Raphael B, Altinyay ME, Castellon I, Libes R, Sandella N, Heiba S, Abdel-Dayem H (2007) Impact of PET/CT in comparison with same day contrast enhanced CT in breast cancer management. Clin Nucl Med 32(6):429–434

    Article  PubMed  Google Scholar 

  16. Schmidt GP, Baur-Melnyk A, Haug A, Heinemann V, Bauerfeind I, Reiser MF, Schoenberg SO (2008) Comprehensive imaging of tumor recurrence in breast cancer patients using whole-body MRI at 1.5 and 3 T compared to FDG-PET–CT. Eur J Radiol 65(1):47–58

    Article  PubMed  Google Scholar 

  17. Antoch G, Vogt FM, Freudenberg LS, Nazaradeh F, Goehde SC, Barkhausen J, Dahmen G, Bockisch A, Debatin JF, Ruehm SG (2003) Whole-body dual-modality PET/CT and whole-body MRI for tumor staging in oncology. JAMA 290(24):3199–3206

    Article  PubMed  CAS  Google Scholar 

  18. Lu WL, Jansen L, Post WJ, Bonnema J, Van de Velde JC, De Bock GH (2009) Impact on survival of early detection of isolated breast recurrences after the primary treatment for breast cancer: a meta-analysis. Breast Cancer Res Treat 114(3):403–412

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Breast Oncology, The National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama, 791-0280, Japan

    Shozo Ohsumi, Sachiko Kiyoto, Fumikata Hara, Mina Takahashi, Daisuke Takabatake, Seiki Takashima, Kenjiro Aogi & Shigemitsu Takashima

  2. Department of Radiology, The National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama, 791-0280, Japan

    Takeshi Inoue

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  1. Shozo Ohsumi
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  2. Takeshi Inoue
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  3. Sachiko Kiyoto
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  4. Fumikata Hara
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  7. Seiki Takashima
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  8. Kenjiro Aogi
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  9. Shigemitsu Takashima
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Correspondence to Shozo Ohsumi.

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Ohsumi, S., Inoue, T., Kiyoto, S. et al. Detection of isolated ipsilateral regional lymph node recurrences by F18-fluorodeoxyglucose positron emission tomography–CT in follow-up of postoperative breast cancer patients. Breast Cancer Res Treat 130, 267–272 (2011). https://doi.org/10.1007/s10549-011-1561-8

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  • DOI: https://doi.org/10.1007/s10549-011-1561-8

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