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General Clinical Specialties: General Practice-OncologyBreast and Sentinel Node Imaging |
1 Radiology; 2 ; 3 Oncology, Albany Medical College, Albany, New York
352
Objectives: There is abundant literature about FDG PET applications in female patients with breast cancer but little is known about its clinical usefulness in males who are rarely affected by this malignancy. Our objective was to review our experience in this population.
Methods: Retrospective study of all FDG PET scans performed in male pts with breast cancer. PET findings were compared with diagnostic contrast–enhanced CT performed 1- 5 weeks before the PET study. Fourteen scans were reviewed (6 initial staging and 8 restaging studies in 5 pts)by a nuclear physician blinded to the original PET report and diagnostic CT films. Gold standard was biopsy(16 lesions), long-term follow-up (13-39 months mean 22 months)(27 lesions)or obvious normal or benign findings on CT (3 lesions).
Results: PET identified 14 avid lesions and CT 9 lesions on initial staging. On restaging studies, PET identified 32 and CT 23 foci. There were 30 PET+ CT+ (all TP), 14PET+ CT- (11TP and 3 FP) and 2 PET- CT+ foci (1 TN and 1 FN).Patient-based sensitivity was the same for both modalities (100%). However lesion-based sensitivity was 97% for PET and 74% for CT. Overall, as a result of adding PET to the work-up, disease was upstaged in 5/14 scans (2 staging and 3 restaging) and downstaged in 1. Management was altered in 3/11 pts after PET.
Conclusions: PET is more sensitive than CT alone for staging and follow-up of male breast cancer and affects management in about 25% of patients.
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