Subtype-Guided 18F-FDG PET/CT in Tailoring Axillary Surgery Among Patients with Node-Positive Breast Cancer Treated with Neoadjuvant Chemotherapy: A Feasibility Study.

CONCLUSION: Application of the subtype-guided 18F-FDG PET/CT could accurately predict nodal response and aid in tailoring axillary surgery among patients with node-positive breast cancer after NAC, which includes identifying candidates appropriate for TAD or directly proceeding to ALND. This approach might help to avoid false-negative events in TAD.
IMPLICATIONS FOR PRACTICE: This feasibility study showed that 18[F]-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) could accurately predict nodal response after neoadjuvant chemotherapy (NAC) among patients with breast cancer with initial nodal metastasis except in estrogen receptor-negative, human epidermal growth factor receptor 2-positive subtype. Furthermore, the incorporation of 18F-FDG PET/CT can tailor subsequent axillary surgery by identifying patients with residual nodal disease, thus sparing those patients supplementary axillary lymph node dissection. Finally, we have proposed a possibly feasible flowchart involving 18F-FDG PET/CT that might be applied in post-NAC axillary evaluation.
PMID: 31826976 [PubMed - as supplied by publisher]

Source: The Oncologist - December 10, 2019 Category: Cancer & Oncology Authors: Wu S, Wang Y, Li J, Zhang N, Mo M, Klimberg S, Kaklamani V, Cochet A, Shao Z, Cheng J, Liu G Tags: Oncologist Source Type: research