Authors' objectives:

To study the diagnostic effectiveness of FDG-PET in breast cancer, and to establish the scientific evidence for different clinical indications. Technology PET included coincidence PET camera, dedicated PET, PET mammography device or the combined PET-CT system. Another purpose of this study was the comparison of PET with other conventional diagnostic methods.

Authors' recommendations: 1) For initial nodal staging, PET could be useful to confirm tumor infiltration in certain risk groups of patients. For patients in the early stages or with tumors less than 1cm, PET is not advisable to assess the extent to nodes by their limited spatial resolution.2) There is enough evidence to confirm the high diagnostic performance of PET or PET-CT in patients with recurrent breast cancer, so it is recommended to include this technology in the diagnostic algorithms and routine clinical management of these patients.3) PET is a valuable clinical tool for the study of distant metastases in the initial pre-treatment in patients with tumors in advanced stage.4) PET is very useful in re-staging of breast cancer when a recurrence has been confirmed and to identify the location of that tumor recurrence in cases where it is suspected only by the increased of tumor markers. To study bone metastasis, FDG-PET and bone scintigraphy are complementary.5) PET seems a safety technology, which has not been associated with side effects or complications at the time of testing.6) As with other diagnostic tests that involve ionizing radiation, it is necessary to make good use of PET and PET-CT, especially with the latter due to both PET and CT radiation in addition to those from the contrast agents, if these are applied.7) Further studies of quality and more homogeneous are needed, so that it is possible to compare and integrate results for assessing the diagnostic performance provided by the PET-CT and PET mammography device, which could be higher than that of dedicated PET for all clinical indications.8) It is necessary to study the clinical impact that PET would have in the management of these patients in different situations, consider the benefits to the patient (reduction of the number of diagnostic tests and ineffective treatments, changes in the therapeutic modality, side effects avoided) and social benefits (cost savings by avoiding unnecessary diagnostic procedures, ineffective treatments or inappropriate hospital stays).9) Since progress in new forms of treatment more individualized to specific cellular receptors is increasingly a reality, it is also expected to advance in molecular imaging, so that the use of PET radiopharmaceuticals to visualize these receptors could contribute not only to a better and more detailed diagnosis, but also to predict the response to these treatments.

Project Status: Completed

URL for project: http://www.isciii.es/htdocs/publicaciones/documentos/60_PET_FDG_en_Ca_de_mama.pdf

Year Published: 2009

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Agencia de Evaluacion de Tecnologias Sanitarias

Contact Address: Instituto de Salud "Carlos III", Calle Sinesio Delgado 6, Pabellon 4, 28029 Madrid, Spain. Tel: +34 9 1 822 2005; Fax: +34 9 1 387 7841;

Contact Name: Luis M. Sánchez Gómez

Contact Email: luism.sanchez@isciii.es

Copyright: Agencia de Evaluacion de Tecnologias Sanitarias (AETS)