The predictive value, sensitivity, specificity, and accuracy of PET CT in the evaluation of axillary metastases in breast cancer

OBJECTIVE: This study aims to evaluate the accuracy of preoperative 18F-FDG PET CT in detecting axillary lymph node (ALN) metastases in patients with breast cancer.PATIENTS AND METHODS: A retrospective analysis was performed on the medical records of 114 patients who underwent PET CT for breast cancer between January 2017 and January 2020. Clinicopathological features and the relation-ship between lymph node metastasis were eval-uated. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated based on the PET CT findings compared to histopathological results.RESULTS: Among the 67 patients included in this study, 29 were identified as having no ax-illary involvement, while 38 showed axillary in-volvement according to preoperative PET CT. Of the 34 patients with histopathologically con-firmed metastatic lymph nodes, 28 had PET CT-detected axillary involvement, while 6 did not. Similarly, among the 33 patients without histopathological evidence of lymph node me-tastasis, 23 had no axillary involvement accord-ing to PET CT, while 10 showed axillary involve-ment. The calculated values were as follows: sensitivity = 82.4% (67-92%), specificity = 69.7% (53-83%), positive predictive value = 73.7% (62-83%), negative predictive value = 79.3% (64%-89%), and accuracy = 76.1% (64-86%). CONCLUSIONS: The results suggest that preoperative 18F-FDG PET CT, particularly p SU-Vmax, can serve as an independent prognostic factor for ALN metastasis in breast cancer pa-tients. Therefore, it may be beneficial for preop-erative risk stratification and personalized treat-ment planning.