Detection of the Metabolic Relationship Between Primary Tumor in Breast Cancer According to Molecular Classification in Positron Emission Tomography; Retrospective Cohort Study

Ahmet Alyanak, Ferit Aslan

Abstract

The main objective of the study was to investigate whether the maximum SUV emission tomography values of Positron differ between luminal molecular properties. The second objective was to examine the relationship between positron emission tomography SUV max and ki67 in primary tumors and axillary lymphadenopathy. In the study between January 2018 and December 2020, 158 patients with stage 1-2-3 breast cancer admitted to the outpatient clinic of general surgery and medical oncology Yüksek htisas University Medicalpark Ankara were retrospectively evaluated. The results of the study considering the relationship between molecular properties and metabolic activity of primary tumors, found a significant relationship between grade (p<0.005), estrogen receptor (p:0.019), and progesterone receptor (p:0.045). More important differences were observed in the luminal type, especially between such as basal and luminal A (p: 0.021). A significant correlation was found in the Pearson correlation test, which was performed between the primary tumor and the SUV values for maxillary axillary lymphadenopathy (p < 0.001, correlation coefficient: 0.331). For Ki67, there was a significant, albeit low, correlation between the SUV max primary tumors (p: 0.026, correlation coefficient 0.179). Although there is a statistically positive trend between Ki67 and axillary SUV max, there is no significant difference (p: 0.06 correlation coefficient: 0.157) In conclusion, we found a significant relationship between max. positron emission tomography SUV, estrogen receptor, progesterone receptor, grade, ki67, and molecular subtypes such as basal and luminal A of the tumor. We found a correlation between the primary tumor and the metabolic activity of axillary lymphadenopathy. It will be meaningful to plan treatment and follow-up according to these results.

Keywords

Breast cancer; positron emission tomography; fluorodeoxyglucose; SUV max; ki67.

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References

Can A., Alacacioglu A., Kucukzeybek, Y., Erten, C. Cokmert, S., Demir, Lütfiye E., Tarhan, M. O. (2013). The relationship of insulin resistance and metabolic syndrome with known breast cancer prognostic factors in postmenopausal breast cancer patients. J Buon, 18, 845-50.

Coates AS, Winer EP, Goldhirsch A, Gelber RD, Gnant M, Piccart-Gebhart M, et al. (2015). Panel Members. Tailoring therapies--improving the management of early breast cancer: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015. Ann Oncol, 26(8),1533-46. doi: 10.1093/annonc/mdv221.

Garcia Vicente AM, Soriano Castrejón Á, León Martín A, Chacón López-Muñiz I, Muñoz Madero V, et al. (2013). Molecular subtypes of breast cancer: metabolic correlation with ¹⁸F-FDG PET/CT. Eur J Nucl Med Mol Imaging, 40(9), 1304-11. doi: 10.1007/s00259-013-2418-7.

Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thürlimann B, Senn HJ, et al. (2011). Strategies for subtypes – dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol, 22, 1736–47.

Heudel P, Cimarelli S, Montella A, Bouteille C, Mognetti T. (2010). Value of PET-FDG in primary breast cancer based on histopathological and immunohistochemical prognostic factors. Int J Clin Oncol, 15(6), 588-93. doi: 10.1007/s10147-010-0120-3.

Higuchi T, Nishimukai A, Ozawa H, Fujimoto Y, Yanai A, Miyagawa Y, et al. (2016). Prognostic significance of preoperative 18F-FDG PET/CT for breast cancer subtypes. Breast, 30, 5-12. doi: 10.1016/j.breast.2016.08.003. Epub 2016 Aug 29.

Kim YH, Yoon HJ, Kim Y, Kim BS. (2015). Axillary Lymph Node-to-Primary Tumor Standard Uptake Value Ratio on Preoperative (18)F-FDG PET/CT: A Prognostic Factor for Invasive Ductal Breast Cancer. J Breast Cancer, 18(2), 173-80. doi: 10.4048/jbc.2015.18.2.173.

Kitajima K, Fukushima K, Miyoshi Y, Nishimukai A, Hirota S, Igarashi Y, Katsuura T, Maruyama K, Hirota S. (2015). Association between ¹⁸F-FDG uptake and molecular subtype of breast cancer. Eur J Nucl Med Mol Imaging, 42(9), 1371-7. doi: 10.1007/s00259-015-3070-1.

Kitajima, K., Miyoshi, Y., Yamano, T. et al. (2018). Prognostic value of FDG-PET and DWI in breast cancer. Ann Nucl Med, 32, 44–53.

Muzahir S. (2020). Molecular Breast Cancer Imaging in the Era of Precision Medicine. AJR Am J Roentgenol, 215(6), 1512-1519. doi: 10.2214/AJR.20.22883.

O, J.H., Choi, W.H., Han, E.J. et al. (2013). The Prognostic Value of 18F-FDG PET/CT for Early Recurrence in Operable Breast Cancer: Comparison with TNM Stage. Nucl Med Mol Imaging, 47, 263–267.

Sasaki M, Tozaki M, Kubota K, Murakami W, Yotsumoto D, Sagara Y, et al. (2018). Simultaneous whole-body and breast 18F-FDG PET/MRI examinations in patients with breast cancer: a comparison of apparent diffusion coefficients and maximum standardized uptake values. Jpn J Radiol, 36(2), 122-133. doi: 10.1007/s11604-017-0707-y.

Son SH, Kim DH, Hong CM, Kim CY, Jeong SY, Lee SW, et al. (2014). Prognostic implication of intratumoral metabolic heterogeneity in invasive ductal carcinoma of the breast. BMC Cancer, 14, 585. doi: 10.1186/1471-2407-14-585.

Surov A, Meyer HJ, Wienke A. (2019). Associations Between PET Parameters and Expression of Ki-67 in Breast Cancer. Transl Oncol, 12(2), 375-380. doi: 10.1016/j.tranon.2018.11.005. Epub 2018 Dec 3.

Van Mechelen M, Van Herck A, Punie K, Nevelsteen I, Smeets A, Neven P, et al. (2020). Behavior of metastatic breast cancer according to subtype. Breast Cancer Res Treat, 181(1), 115-125. doi: 10.1007/s10549-020-05597-3. Epub 2020 Mar 19. Erratum in: Breast Cancer Res Treat. 2021

Wang J, Shih TT, Yen RF. (2017). Multiparametric Evaluation of Treatment Response to Neoadjuvant Chemotherapy in Breast Cancer Using Integrated PET/MR. Clin Nucl Med, 42(7), 506-513.

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