Contribution of fluorodeoxyglucose-positron emission tomography late imaging to diagnosis and correlation with histopathology in invasive lobular breast cancer

Abstract

Objective: The aim of this study was to investigate tie correlation between primary lesion and contralateral breast tissue metabolic parameters in standard and delayed images obtained on preoperative F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) and tie correlation with pathological variables of primary lesion in invasive lobular breast cancer (ILC). Methods: Seventeen ILC cases in which standard and late FDG-PET imaging were performed between 2007 and 2018 were included in the study. SUVmax, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values and change rates (Delta) of primary malignant lesion and contralateral breast control area were recorded. T and N stages, Histological and nuclear grades of primary malignancy, estrogen receptor (ER), progesterone receptor, presence of human epidermal growth factor receptor (HER)-2 and Ki-67 values are compared with FDG-PET values. Results: No statistically significant correlation was found between metabolic parameters and histopathological components of 17 ILC patients (median age: 45 years) after surgery (11 breast conserving surgery, 6 mastectomy). Among the metabolic parameters obtained from contralateral breast tissue, SUVmax-based ones [standard(s) SUVmax, late(g)-SUVmax, Delta SUVmax] showed statistically significant differences with malignancy (p<0.000). Conclusion: Especially the negative median value of tie control SUVmax suggests that late imaging may provide additional contribution, especially in the dense breast tissue, in the ILC wits high probability of multifocality/multicentricity Although there was no statistically significant difference with histopatnological components, parallel results (such as high Delta-TLG in presence of lymph node metastasis, HER-2 positive and high SUVmax, MTV and TLG median values in ER negative cases) were seen with the literature mostly consisting of invasive ductal carcinoma. Confirmation of this important information obtained only from ILC patients is required in multicentre studies or meta analyzes in which the number of cases will be higher.