Breast Cancer: Comparison Study between Early Stage and Locally Advanced Disease

Aim: Initial staging in breast cancer is considered as locoregional and systemic disease. Distant metastases is rarely expected in early stage breast cancer patients. Although, we observed that, stage is not as clinically expected after staging with FDG PET-CT both in early and advanced stage breast cancer. Our main objective was to test the hypothesis by comparing the distant metastases rate on initial FDG PET-CT in a group of early stage to advanced stage breast cancer patients. Assessment of associations between distant metastases and tumor T stage was a second objective of the present retrospective study. Materials and methods: A total of 114 patients with breast cancer (age range: 25-77, mean: 51.1) who underwent PET-CT for initial staging were enrolled. All patients were diagnosed by tru-cut, core or FNAB before imaging and had confirmed breast malignancy. Results: The mean SUVmax of primary breast lesions in a total of 114 patients was found to be 7.64 (range: 1.45-20.94). PET-CT detected distant metastasis in 24 of the 114 patients. Of the total 34 metastatic regions, 41.1% (14/34) was bone/bone marrow metastasis, 5.9 % (2/34) was lung metastasis, 14.7 % (5/34) was mediastinal lymph node metastasis, 5.9 % (2/34) was liver metastasis, 5.9 % (2/34) had other organ/system metastasis, and 26.5 % (9/34) had other lymphadenopathies. According to T staging, the percentages of distant metastasis were as follows: 6.5 % of the 46 T1 stage patients, 23.6 % of the 55 T2 stage patients, and 88.8 % of the 9 T4 stage patients. Conclusion: FDG PET-CT led to a change in the stage of disease and the treatment approach in newly diagnosed breast cancer in both early stage or advanced stage patients. PET-CT imaging in patients with T1c to T4 breast lesions are suggested to underwent PET-CT examinations for cancer initial staging before any treatment.