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ORIGINAL ARTICLE
Year : 2018  |  Volume : 17  |  Issue : 4  |  Page : 275-280

Prognostic factors in breast cancer patients evaluated by positron-emission tomography/computed tomography before neoadjuvant chemotherapy


1 Department of Medicine, Mary Babb Randolph Cancer Center; Department of Radiation Oncology, West Virginia University, Morgantown, West Virginia 26505, USA
2 Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia 26505, USA
3 Department of Medicine, Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, West Virginia 26505, USA

Correspondence Address:
Mark K Farrugia
Department of Medicine, Mary Babb Randolph Cancer Center, West Virginia University, 1 Medical Center Dr, Morgantown, West Virginia 26505
USA
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DOI: 10.4103/wjnm.WJNM_84_17

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Neoadjuvant chemotherapy (NAC) is a significant modality in breast cancer therapy. We sought to characterize prognostic factors in patients scheduled for NAC who had a pretreatment positron-emission tomography paired with diagnostic quality contrast-enhanced computed tomography (CT) (positron-emission tomography/CT [PET/CT]). A total of 118 breast cancer patients were analyzed through chart review who underwent pretreatment PET/CT imaging and received NAC from 2008 to 2014. We collected information on molecular markers, PET/CT, pathologic complete response (pCR), survival, and disease status. Pretreatment standard uptake value (SUV) max of the primary breast tumor showed no relationship to pCR; however, there was a statistically significant relationship with relapse-free survival (RFS) using univariate cox regression (P = 0.03, odds ratio (OR) = 1.06 [1.01–1.12]) with comparable findings observed with overall survival (OS). Multivariate analysis revealed SUV max to be significantly correlated with shortened OS (P = 0.022, OR = 1.08 [1.01–1.16]), with a similar trend reported for RFS. By pathological subtype, this correlation was the strongest within hormone receptor (HR+)/human epidermal growth factor receptor 2 (HER2−) tumors. In addition, Kaplan–Meier estimates demonstrated a significant difference between the RFS of triple-negative tumors and HER2 positive tumors (P = 0.001). Interestingly, within this cohort, multivariate Cox regression analysis showed HER2 positivity to be associated with favorable outcome (P = 0.04, HR = 0.22 [0.05–0.94]). These findings demonstrate a significant association between SUV max of HR+/HER2−− tumors and relapse-free and OS. Furthermore, highlighted here is the favorable survival in the once classically aggressive HER2+ breast cancer subgroup.


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