الفهرس 
AbstractOnly 14 pages are availabe for public view
 |  | from | 107 |  |  |
| | | from | 107 | | |
Abstract
We assess in our study the role of F18 FDG-PET/CT in management of BC patients .This is prospective study in which one hundred female patients with biopsy-proven breast cancer were evaluated after a written signed consent was obtained at the PET/CT unit of the Assuit University Hospital Over a period of 2 years. The protocol of the study was approved by the ethical committee. All the 100 cases were females ((age range, 26-78 years ; mean age 49.73 +/-11.71years). Among the 100 patients 48 were having right breast cancer, 47 ones were having left breast cancer and 5 were having bilateral disease involvement. Patients included in the study were classified according to the time of presentation and the clinical cause of referral into two groups: group A: FDG-PET/CT study was performed for 40 patients for initial staging before therapy . In all cases the primary lesions detected as hyper metabolic lesions with 27 patients had positive ALN FDG uptake and 5 patients with metabolically active distant metastasis. group B: FDG-PET/CT study was performed in 60 patients for variable indications during therapy and follow up. 10 patients had positive ALN FDG uptake , 13 extra axillary LNs involvement and metabolically active liver lesions in 11 cases, lung lesions in 7 cases, bone lesions in 23 cases (2 sclerotic,7 lytic ,14 Mixed) , brain lesions in one patient and multiple metastatic lesions (Bone ,Liver &lung ) in 3 patients . PET/CT successfully diagnoses local recurrence in 2 cases. Out of the 60 patients only 10 cases had whole body MRI which detects brain lesions in one case, lung lesions in one case, liver lesions in 5 cases, bone lesions in one case and (both bone and liver) lesions in 2 patients. 4 out of those 10 cases with positive lesions in MRI had corresponding high metabolic activity in PET/CT. PET/CT and CT agreed in 20 true negative cases and 27 true positive cases. -Out of the 60 patients only 13 cases had bone scan which detect osseous lesions in 6 cases all had corresponding metabolic activity in F18 PET/CT study and was free in7 cases in which F18 PET/CT also had no osseous lesions. F18 FDG PET CT incidentally discovered contralateral metabolically active breast lesions in 2 patients that proved to be IDC in histopathology. We concluded that FDG-PET-CT seems to be highly useful for breast cancer’s diagnosis, staging, re-staging, and treatment response assessment. -PET/CT proved to be an efficient, accurate and non-invasive imaging technique in detecting metastatic disease with subsequent modification of the patient staging which is reflected on the patients’ management planes especially in locally advanced and advanced stages breast cancer. -In the initial stage assessment, preoperative FDG-PET/CT has a substantial impact on staging and on clinical management and we suggest that PET/CT could be considered in the initial assessment of patients with newly diagnosed node-positive early-stage breast cancer. -PET/CT is a valuable tool PET/CT is a valuable tool in staging in specific circumstances:. Neoadjuvant therapy is planned without axillary dissection.. Equivocal findings are seen on CT, ultrasound, or MRI, bone scan. -Breast cancer patients with higher primary tumor 18F-FDG uptake are at higher risk of concurrent ALNM. - PET/CT is a valuable tool to provide information on extra-axillary lymph node involvement, distant metastases and other occult primary cancers. -We recommend further studies with larger sample size and other metabolic parameters to validate our results. -We recommend further studies for association of metabolic parameters with other prognostic factors including Ki67 proliferation index and tumor markers. - We recommend long term follow up of patients after treatment to accurately assess the patient survival.