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Abstract
Purpose
The aim of this study is to evaluate whether low FDG uptake would be associated with the biological low-aggressiveness of invasive ductal carcinoma.
Methods
The subjects consisted of 124 female patients with primary invasive ductal carcinoma. All the patients were examined with 18F-FDG PET/CT before neoadjuvant chemotherapy.
Results
With regard to histopathologic grading, 117 were histopathologic grade 1 and 2, and 7 were grade 3. Low FDG uptake correlated with well and moderate histopathologic grade (p=0.003) and low 18F-FDG uptake in invasive ductal carcinoma depended on the presence of axillary lymph node metastases (p=0.014) and small tumor (<2.0 cm, p=0.022). Ki-67 positivity ranged from 0% to 60% (mean 15%). Sixty seven specimens showed low immunoreactivity to Ki-67 antigen (<10% of tumor cells). This revealed a significant correlation between low FDG uptake and Ki-67 (p=0.003). Logistic regression analysis between these factors showed that lower histologic grade, no axillary lymph nodes metastases and low Ki-67 (<10%) were correlated with low FDG uptake.
Figures and Tables
 | Figure 1(A) 18FDG PET/CT shows increased FDG uptake of right breast (arrow) and ipsilateral axillary LN (*). (B) Microscopic appearance of the specimen shows grade 3. (C) It is metastasized to axillary lymph node. (D) Ki-67 ratio is 40%.
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 | Figure 2(A) It is a false-negative finding at 18F-FDG-PET/CT during staging of left breast cancer in 58-yr-old woman and 18F-FDG-PET/CT image shows low FDG uptake. (B) Microscopic appearance of the specimen is grade 1. (C) It doesn't show axillary lymph node metastasis. (D) Ki-67 ratio is 1%.
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Table 1
Clinicopathologic factors affecting low FDG uptake in 18F-FDG PET/CT for invasive ductal cancer
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