Using PET/CT Imaging to Predict Disease Progression in Metastatic Breast Cancer

By: Joshua D. Madera, MD
Posted: Wednesday, September 25, 2024

For patients with breast cancer, the extent of disease spread identified on baseline PET may be a predictive factor of those experiencing disease progression, according to a study published in Cancer Imaging. These findings may influence therapeutic strategies in clinical follow-up for this patient population, explained Charline Lasnon, MD, PhD, of the François Baclesse Comprehensive Cancer Center, Caen, France, and colleagues.

“In the absence of early metabolic progression, treatment should be continued regardless of the quality of the initial response to treatment,” suggested the study authors regarding the clinical utility of 18F-FDG PET imaging.

A total of 66 patients with histologically proven estrogen receptor–positive, HER2-negative metastatic breast cancer were recruited for the study. Patients were previously treated with a CDK inhibitor and an endocrine therapy. All underwent a pretherapeutic 18F-FDG PET/CT scan and a second PET/CT scan after treatment. The extent of metabolic tumor volume, total lesion glycolysis, and tumor dissemination (D_max) were calculated using the scans from the imaging studies. Patients were closely monitored to assess their clinical outcomes.

The study authors reported evidence of disease progression in 45.4% of patients. The only predictive metabolic parameter was D_max. A significantly improved 18-month progression-free survival was observed in patients with a D_maxless than or equal to 18.1 cm (69.2%) compared with the other patients (36.7%). Furthermore, the 18-month progression-free survival was comparable between patients classified as having stable metabolic disease and those classified as being complete, partial metabolic responders.

Disclosure: The study authors reported no conflicts of interest.

Cancer Imaging