Role of F-18 FDG PET/CT in Predicting Response to Neoadjuvant Chemotherapy in Invasive Ductal Breast Cancer

Eur J Breast Health. 2023 Apr 1;19(2):159-165. doi: 10.4274/ejbh.galenos.2023.2023-1-3. eCollection 2023 Apr.


Objective: The role of baseline and post-treatment standardized uptake value (SUVmax) values in predicting pathological response in patients with breast cancer after neoadjuvant chemotherapy (NAC).

Materials and methods: Thirty patients with invasive ductal breast cancer were included in this retrospective study. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) examinations were performed before and after NAC. Pretreatment SUVmax (SUVmax I), post-treatment SUVmax (SUVmax II) and ΔSUVmax values of primary breast cancer were obtained. Breast tumor pathology preparations were examined for the evaluation of tumor response according to the Miller and Payne classification. Patients were grouped as responding to treatment (pCR) and unresponsive to treatment (nonpCR). In all analyses, p<0.05 was considered statistically significant.

Results: The mean age of the 30 patients included in the study was 51.2±11.98 years. In the study-defined grouping, 13 patients (43.3%) were nonresponders and 17 patients (56.7%) were responders. ΔSUVmax was significantly greater in the responders group compared to the nonresponders group, while SUVmax II was lower (p = 0.001 and p = 0.004, respectively). There was no significant difference between the responders and nonresponders in terms of age, tumor diameter, and SUVmax I values. Multivariate logistic regression analysis showed ΔSUVmax to be the only independent predictive factor for pCR.

Conclusion: F-18 FDG PET/CT was an effective method in evaluating the treatment response after NAC in breast cancer, and ΔSUVmax and post-treatment SUVmax can be used to predict the response of the primary tumor to treatment.

Keywords: Breast cancer; F-18 FDG; SUVmax; neoadjuvant chemotherapy.