A CROSS SECTIONAL STUDY OF CORRELATION OF PRIMARY TUMOR FDG UPTAKE WITH CLINICOPATHOLOGIC PROGNOSTIC FACTORS IN INVASIVE DUCTAL CARCINOMA OF BREAST

Abstract

Introduction: Breast cancer is a heterogeneous disease with a broad range of therapeutic responses, recurrence risk, and overall prognosis [1]. The management and prognosis of breast cancer depend on the size, histologic grade, hormonal receptor status and status of HER2. 18F-FDG PET/CT has been widely used in breast cancer patients [9]. Integrated PET/CT, which combines anatomic and metabolic imaging information, has shown to further improve diagnostic accuracy through accurate localization of functional data on CT images. Combined with DCECT it can be used to evaluate tumor aggressiveness, therapeutic response and radiotherapy planning [6]. Aim: Purpose of this study is to correlate the primary tumor FDG uptake with clinicopathologic prognostic factors in invasive ductal carcinoma of the breast. Material And Methods: This was a prospective Cross-sectional study study conducted at Apollo hospital, Jubilee hills, Hyderabad. A total of 55 patients diagnosed with invasive ductal carcinoma of the breast were included in the study. FDG PET/CT was performed on Siemens Biograph 16 slice PET CT machine and the data was reconstructed by iterative methods. Data was expressed as mean ± SDs and relationship between pSUVmax, clinicopathological parameters were evaluated using the student's t-test. It was regarded as statistically signicant when p-values are less than 0.05 with a condence interval of 95%. Results: A total of 55 patients were included (Mean age: 48.4 ± 8.5 yrs; Menopause:52.7%; Child birth:70.9%; Family history: 60%).Majority belonged to histological grade grade 3 (36.3%) , axillary lymph nodal positive patients belonged to TNM stage II. SUVmax was higher in ER, PR negatives (13.2 ± 3.0; 13.8 ± 5.4), axillary lymph node positives (10.1 ± 5.2), higher tumor stage and higher tumor grade. lower in patients with ER, PR positives (4.9 ± 2.4; 5.1 ± 2.3), axillary lymph node negatives (3.0 ± 1.5). The SUVmax values for T4 stage, p TNM stage IV and Grade3 tumors were 20.4 ± 2.0; 17.1 ± 3.5; and 13.2 ± 3.2 respectively. Conclusion: In the study, signicant correlation was found between 18F-FDG uptake and clinicopathologic variables. SUVmax was signicantly higher in patients who were premenopausal women, higher tumor stage, higher histological grade, ER, PR negatives and positive axillary lymph node status. These ndings were akin to most of the studies done using identical parameters and variables.