2-[18f]-Fluoro-2-deoxy-d-glucose positron emission tomography in the evaluation of breast lesions and axillary involvement: a comparison with mammography and histopathological diagnosis

Aim: The objective of this prospective study was to evaluate the potential role of 2-[18f]-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in the differentiation of malignant and benign breast masses and the evaluation of axillary lymph node involvement. The secondary objective of this study was to assess the value of FDG PET in the initial staging of patients with breast cancer. Materials and methods: We evaluated 82 lesions in 79 consecutive patients (mean age of 54.4 +/- 13.0; age range: 25-82 years) with FDG PET. While ultrasounds were performed in all cases, of the 79 patients, 72 had mammography and 58 had whole-body bone scintigraphy. All patients had a histopathological diagnosis made by 2 experienced pathologists. Results: The sensitivity and positive predictive value of FDG PET in the differentiation of breast masses was found as 78% and 98%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of FDG PET in the detection of metastatic axillary invasion was 50%, 76%, 53%, and 64%, respectively. FDG PET changed the stage of 41 patients (52%) by either downstaging [33 (41%) patients] or upstaging [8(11%) patients], respectively. Conclusion: Our results suggest that FDG PET has limited value in differentiating between malignant and benign breast lesions and in the detection of metastatic axillary lymph nodes. However, FDG PET appears to have great impact in the initial staging of patients with breast cancer and could be very helpful in the management of selected cases.