Purpose ASCO guidelines did not recommend the use of biochemical parameters (such as Ca 15.3 and CEA) and CT and PET/CT imaging in women with pervious and already treated breast cancer during follow-up. To assess the role of Ca 15.3, CT and PET/CT in patients with breast cancer (BC) and disease relapse after primary treatment. Methods and Materials We enrolled 111 patients with previous BC and clinical/biochemical suspect of disease relapse. All patients underwent CT and FDG PET/CT. In overall patients, the value of Ca 15.3 was compared to PET/CT and CT. The relapse diagnosis was established by invasive/non-invasive follow-up and it was compared with Ca 15.3, CT and PET/ CT results. Univariate and multivariate analysis were used to identify the independent predictors of relapse and ROC curve for the identification of optimal Ca 15.3 cut-off. Results Of the overall 111, 40 (36%) showed increased Ca 15.3, CT was positive in 73 (66%), whereas 64 (58%) patients had positive PET/CT. Of 40 patients with markers value increase, 22 patients had positive CT and 30 positive PET/CT (55% vs. 75%, p<0.001). At the end of follow-up, recurrence occurred in 32 (29%) patients, whose 16 (50%) showed high levels of Ca 15.3. PET/CT predicted relapse in 26 (81%) patients, whereas CT identified 23 (72%). At univariate analysis, recurrence was significantly associated with high Ca 15.3 values (P<0.05) and positive PET/CT (P<0.005). At multivariable analysis only PET/CT remained an independent predictor of relapse (P<0.05). ROC analysis showed an optimal cut-off point for Ca 15.3 of 19.1 U/mL (AUC 0.65, p<0.01) to individuate positive PET/CT. Conclusion FDG PET/CT is more sensitive than CT and Ca 15.3 in the evaluation of disease relapse and might be considered a complementary imaging technique during BC follow-up.
Tumour marker and FDG PET/CT for prediction of diseaserelapse in patients with breast cancer
POMERRI, FABIO;MUZZIO, PIER CARLO
2011
Abstract
Purpose ASCO guidelines did not recommend the use of biochemical parameters (such as Ca 15.3 and CEA) and CT and PET/CT imaging in women with pervious and already treated breast cancer during follow-up. To assess the role of Ca 15.3, CT and PET/CT in patients with breast cancer (BC) and disease relapse after primary treatment. Methods and Materials We enrolled 111 patients with previous BC and clinical/biochemical suspect of disease relapse. All patients underwent CT and FDG PET/CT. In overall patients, the value of Ca 15.3 was compared to PET/CT and CT. The relapse diagnosis was established by invasive/non-invasive follow-up and it was compared with Ca 15.3, CT and PET/ CT results. Univariate and multivariate analysis were used to identify the independent predictors of relapse and ROC curve for the identification of optimal Ca 15.3 cut-off. Results Of the overall 111, 40 (36%) showed increased Ca 15.3, CT was positive in 73 (66%), whereas 64 (58%) patients had positive PET/CT. Of 40 patients with markers value increase, 22 patients had positive CT and 30 positive PET/CT (55% vs. 75%, p<0.001). At the end of follow-up, recurrence occurred in 32 (29%) patients, whose 16 (50%) showed high levels of Ca 15.3. PET/CT predicted relapse in 26 (81%) patients, whereas CT identified 23 (72%). At univariate analysis, recurrence was significantly associated with high Ca 15.3 values (P<0.05) and positive PET/CT (P<0.005). At multivariable analysis only PET/CT remained an independent predictor of relapse (P<0.05). ROC analysis showed an optimal cut-off point for Ca 15.3 of 19.1 U/mL (AUC 0.65, p<0.01) to individuate positive PET/CT. Conclusion FDG PET/CT is more sensitive than CT and Ca 15.3 in the evaluation of disease relapse and might be considered a complementary imaging technique during BC follow-up.Pubblicazioni consigliate
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