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Physiologic and hypermetabolic breast 18-F FDG uptake on PET/CT during lactation
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Physiologic and hypermetabolic breast 18-F FDG uptake on PET/CT during lactation
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Journal Article
Physiologic and hypermetabolic breast 18-F FDG uptake on PET/CT during lactation
2021
Overview
Objective
To investigate the patterns of breast cancer-related and lactation-related
18
F-FDG uptake in breasts of lactating patients with pregnancy-associated breast cancer (PABC) and without breast cancer.
Methods
18
F-FDG-PET/CT datasets of 16 lactating patients with PABC and 16 non-breast cancer lactating patients (controls) were retrospectively evaluated. Uptake was assessed in the tumor and non-affected lactating tissue of the PABC group, and in healthy lactating breasts of the control group, using maximum and mean standardized uptake values (SUVmax and SUVmean, respectively), and breast-SUVmax/liver-SUVmean ratio. Statistical tests were used to evaluate differences and correlations between the groups.
Results
Physiological uptake in non-breast cancer lactating patients’ breasts was characteristically high regardless of active malignancy status other than breast cancer (SUVmax = 5.0 ± 1.7,
n
= 32 breasts). Uptake correlated highly between the two breasts (
r
= 0.61,
p
= 0.01), but was not correlated with age or lactation duration (
p
= 0.24 and
p
= 0.61, respectively). Among PABC patients, the tumors demonstrated high
18
F-FDG uptake (SUVmax = 7.8 ± 7.2,
n
= 16), which was 326–643% higher than the mostly low physiological FDG uptake observed in the non-affected lactating parenchyma of these patients (SUVmax = 2.1 ± 1.1). Overall,
18
F-FDG uptake in lactating breasts of PABC patients was significantly decreased by 59% (
p
< 0.0001) compared with that of lactating controls without breast cancer.
Conclusion
18
F-FDG uptake in lactating tissue of PABC patients is markedly lower compared with the characteristically high physiological uptake among lactating patients without breast cancer. Consequently, breast tumors visualized by
18
F-FDG uptake in PET/CT were comfortably depicted on top of the background
18
F-FDG uptake in lactating tissue of PABC patients.
Key Points
• FDG uptake in the breast is characteristically high among lactating patients regardless of the presence of an active malignancy other than breast cancer.
• FDG uptake in non-affected lactating breast tissue is significantly lower among PABC patients compared with that in lactating women who do not have breast cancer.
•
In pregnancy-associated breast cancer patients,
18
F-FDG uptake is markedly increased in the breast tumor compared with uptake in the non-affected lactating tissue, enabling its prompt visualization on PET/CT.
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
