Systematic Reviews
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jul 28, 2017; 9(7): 312-320
Published online Jul 28, 2017. doi: 10.4329/wjr.v9.i7.312
Preoperative [18]fluorodeoxyglucose-positron emission tomography/computed tomography in early stage breast cancer: Rates of distant metastases
Vincent Vinh-Hung, Hendrik Everaert, Karim Farid, Navid Djassemi, Jacqueline Baudin-Veronique, Stefanos Bougas, Yuriy Michailovich, Clarisse Joachim-Contaret, Elsa Cécilia-Joseph, Claire Verschraegen, Nam P Nguyen
Vincent Vinh-Hung, Stefanos Bougas, Department of Radiation Oncology, University Hospital of Martinique, Fort-de-France 97200, Martinique
Hendrik Everaert, Department of Nuclear Medicine, Universitair Ziekenhuis Brussel, Brussels 1090, Belgium
Karim Farid, Department of Nuclear Medicine, University Hospital of Martinique, Fort-de-France 97200, Martinique
Navid Djassemi, Ross University School of Medicine, Miramar, FL 33027, United States
Jacqueline Baudin-Veronique, Cancer Research Department, University Hospital of Martinique, Fort-de-France 97200, Martinique
Yuriy Michailovich, Cancer Control Department, National Cancer Institute, Kyiv 03022, Ukraine
Clarisse Joachim-Contaret, Cancer Registry of the Martinique, Fort-de-France 97200, Martinique
Elsa Cécilia-Joseph, Biostatistics, Sciences Department, Schoelcher Campus of the University of the French West Indies, 97233 Schoelcher, Martinique
Claire Verschraegen, Department of Medical Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, United States
Nam P Nguyen, Department of Radiation Oncology, Howard University, Washington, DC 20060, United States
Author contributions: Vinh-Hung V and Nguyen NP conceptualized and designed the review; Nguyen NP carried out the analysis and drafted the initial manuscript; Cécilia-Joseph E reviewed the statistics; Vinh-Hung V, Everaert H, Farid K, Djassemi N, Baudin-Veronique J, Bougas S, Michailovich Y, Joachim-Contaret C, Cécilia-Joseph E and Verschraegen C contributed to the literature search, interpretation of the data, and critical revisions; all authors reviewed and approved the final manuscript as submitted.
Conflict-of-interest statement: The authors declare no conflicts of interests for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Vincent Vinh-Hung, MD, PhD, Chair, Department of Radiation Oncology, University Hospital of Martinique, Bld Pasteur, Fort-de-France 97200, Martinique.
Telephone: +596-696-542019
Received: March 28, 2017
Peer-review started: March 29, 2017
First decision: April 18, 2017
Revised: May 20, 2017
Accepted: June 19, 2017
Article in press: June 20, 2017
Published online: July 28, 2017

To investigate rates of distant metastases (DM) detected with [18]fluorodeoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT) in early stage invasive breast cancer.


We searched the English language literature databases of PubMed, EMBASE, ISI Web of Knowledge, Web of Science and Google Scholar, for publications on DM detected in patients who had 18FDG-PET/CT scans as part of the staging for early stages of breast cancer (stage I and II), prior to or immediately following surgery. Reports published between 2011 and 2017 were considered. The systematic review was conducted according to the PRISMA guidelines.


Among the 18 total studies included in the analysis, the risk of DM ranged from 0% to 8.3% and 0% to 12.9% for stage I and II invasive breast cancer, respectively. Among the patients with clinical stage II, the rate of occult metastases diagnosed by 18FDG-PET/CT was 7.2% (range, 0%-19.6%) for stage IIA and 15.8% (range, 0%-40.8%) for stage IIB. In young patients (< 40-year-old), 18FDG-PET/CT demonstrated a higher prevalence of DM at the time of diagnosis for those with aggressive histology (i.e., triple-negative receptors and poorly differentiated grade).


Young patients with poorly differentiated tumors and stage IIB triple-negative breast cancer may benefit from 18FDG-PET/CT at initial staging to detect occult DM prior to surgery.

Keywords: Breast cancer, Early stage, Staging workup, Distant metastases, [18]fluorodeoxyglucose-positron emission tomography/computed tomography scan

Core tip: This systematic review identifies groups of patients with early stage breast cancer who might benefit most from [18]fluorodeoxyglucose-positron emission tomography/computed tomography (commonly known as 18FDG-PET/CT) scan at initial staging, prior to surgery.