Assessment of response to endocrine therapy using FDG PET/CT in metastatic breast cancer: a pilot study

Eur J Nucl Med Mol Imaging. 2012 Mar;39(3):450-60. doi: 10.1007/s00259-011-1981-z. Epub 2011 Dec 20.


Purpose: The purpose of this pilot study was to assess whether outcome in metastatic or recurrent breast cancer patients is related to metabolic response to endocrine therapy determined by (18)F-FDG PET/CT.

Methods: The study group comprised 22 patients with breast cancer (age 58 ± 11 years, mean ± SD) who were scheduled to receive endocrine therapy. They were systematically assessed by PET/CT at baseline and after a mean of 10 ± 4 weeks for evaluation of response after induction. All patients demonstrated FDG-avid lesions on the baseline PET/CT scan. The metabolic response was assessed according to EORTC criteria and based on the mean difference in SUV(max) between the two PET/CT scans, and the patients were classified into four groups: complete or partial metabolic response, or stable or progressive metabolic disease (CMR, PMR, SMD and PMD, respectively). All patients were followed in our institution.

Results: Metastatic sites were localized in bone (n = 15), lymph nodes (n = 11), chest wall (n = 3), breast (n = 5), lung (n = 3), soft tissue (n = 1) and liver (n = 1). PMR was observed in 11 patients (50%), SMD in 5 (23%) and PMD in 6 (27%). The median progression-free survival (PFS) times were 20, 27 and 6 months in the PMR, SMD and PMD groups, respectively. PFS in the SMD group differed from that in the PMR and SMD groups (p < 0.0001).

Conclusion: Metabolic response assessed by FDG PET/CT imaging in patients with metastatic breast cancer treated with endocrine therapy is predictive of the patients' PFS.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • Disease-Free Survival
  • Female
  • Fluorodeoxyglucose F18*
  • Hormones / therapeutic use*
  • Humans
  • Middle Aged
  • Mucin-1 / blood
  • Multimodal Imaging*
  • Neoplasm Metastasis
  • Pilot Projects
  • Positron-Emission Tomography*
  • Recurrence
  • Tomography, X-Ray Computed*
  • Treatment Outcome


  • Hormones
  • Mucin-1
  • Fluorodeoxyglucose F18