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The role of positron emission tomography in the detection of recurrence in symptomatic patients with stage II and III breast cance.

720 Background: Imaging modalities such as CT scans, bone scans, and MRI have been used as an adjunct to detect recurrence in high-risk breast cancer patients. The role of positron emission tomography (PET) for patients with Stage II and Stage III breast cancers who present with signs and symptoms suggestive of recurrence is evolving. We report our experience with PET scans for detecting recurrence in this population.


METHODS
Between January 2000 to November 2003, 22 patients with stage II and III breast cancer who present with signs and symptoms of recurrent disease underwent PET scans. These patients also underwent other imaging modalities as part of their work-ups. Patients were staged according to the 2001 AJCC staging system. The PET scan results were correlated with other imaging modalities and/or confirmed by tissue biopsy of suspicious lesions.


RESULTS
Of the 22 patients studied, three patients were excluded for the following reasons: 2 patients had incomplete data, 1 patient had a primary breast sarcoma. There were six patients with stage II breast cancer and thirteen patients who had stage III breast cancer. Overall, there were 11 true positives, five true negatives, and three false negatives. Since there were no false positives, the specificity and positive predictive values were therefore all 100%. The overall sensitivity was 78.6% with an overall negative predictive value of 62.5%. For stage II cancers, PET scan had a sensitivity of 75% and a negative predictive value of 75%. For stage III cancers, PET scan had a sensitivity of 80% and a negative predictive value of 50% (Table 1). [Figure: see text] Conclusion: Positron emission tomography is an effective modality to detect recurrent breast cancer in symptomatic patients with stage II and III disease. No significant financial relationships to disclose.