Impact of preoperative PET/CT for axillary staging in patients with early breast cancer

BACKGROUND: Preoperative evaluation of axillary lymph node status is very important for the choice of primary treatment in breast cancer. This study assessed predictive properties of positron emission tomography-computerized tomography for axillary lymph node metastasis. METHODS: Patients who were operated between 2014-2019 for early breast cancer and who had preoperative positron emission tomography-computerized tomography images were included. Positron emission tomography-computerized tomography results and histopathologic results were compared retrospectively. RESULTS: Medical records of 223 patients who were operated for early breast cancer and have had positron emission tomography-computerized tomography were evaluated. positron emission tomography-computerized tomography revealed that axillary lymph node status is positive in 97 patients and negative in 126 patients. In histopathological examination, tumor cells were found in 86 patients, of those 27 were negative while 59 were positive in positron emission tomography-computerized tomography. Furthermore, 137 patients were free from tumor cells, in which 99 were negative and 38 were positive in positron emission tomography-computerized tomography. Positive and negative predictive value of positron emission tomography-computerized tomography for metastatic axillary lymph nodes were found 60.8% and 78.5%, respectively. CONCLUSIONS: Clinically, positron emission tomography-computerized tomography has low negative predictivity for determination of axilla in early stage or operable breast cancer. Even though it is valuable for the systematic scanning, positron emission tomography-computerized tomography can be overlooked for axillary evolution.