Published online Jul 28, 2017. doi: 10.4329/wjr.v9.i7.312
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 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.
Core tip: This systematic review identifies groups of patients with early stage breast cancer who might benefit most from fluorodeoxyglucose-positron emission tomography/computed tomography (commonly known as 18FDG-PET/CT) scan at initial staging, prior to surgery.