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PET/CT Better Than Traditional Staging for Locally Advanced Breast Cancer Patients
By MedImaging International staff writers Posted on 17 Jan 2013
French researchers have revealed that 18F-fludeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) imaging provides considerable prognostic stratification data at initial staging for patients with locally advanced breast cancer. When compared to conventional imaging, 18F-FDG PET/CT more effectively demonstrated lesions in the abdomen, chest, and bones in only one session, altering management for more than 50% of the patients in the study.
The study’s findings were published in the January 2013 issue of the Journal of Nuclear Medicine. Guidelines from the US National Comprehensive Cancer Network (NCCN) recommend a physical exam, bilateral mammogram, ultrasound, or breast magnetic resonance imaging (MRI) to assess the breast, as well as chest diagnostic CT, abdominal, or pelvic diagnostic CT or MR imaging and bone scanning for the assessment of distant involvement. The NCCN guidelines deem 18F-FDG PET/CT to be “most helpful in situations where standard staging studies are equivocal or suspicious.”
“The prognosis of patients with locally advanced breast cancer remains poor. In this study we aimed to investigate whether the use of 18F-FDG PET/CT at initial staging could have an impact on the prognostic stratification and management of patients with locally advanced breast cancer," said David Groheux, MD, PhD, from the department of nuclear medicine, Saint-Louis Hospital (Paris, France), and lead author of the study.
One hundred and seventeen patients with locally advanced breast cancer were prospectively included in the study over a course of five years. Patients underwent conventional imaging methods, including bone scanning, chest radiography, or dedicated CT and abdominopelvic examination by ultrasound or contrast-enhanced CT and were staged accordingly. They then received an 18F-FDG PET/CT scan, which was reviewed by nuclear medicine specialists with no knowledge of the conventional imaging results. The conventional imaging and 18F-FDG imaging results were then compared.
All primary tumors were detected by 18F-FDG PET/CT. The scans validated lymph node involvement in stage IIIC patients and revealed unanticipated lymph node involvement in 32 additional patients. Moreover, distant metastases (bone, distant lymph nodes, liver, lung, and pleura) were visualized with 18F-FDG PET/CT in 43 patients; conventional imaging only identified 28 patients with distant metastases. Overall, 18F-FDG PET/CT changed the stage of 61 out of 117 patients, which then affected the recommended treatment for the patients.
“This is a step toward the truly personalized medicine that molecular imaging can bring—acquiring an image that provides sufficient information to truly tailor management strategies to the singular needs of each patient,” noted Dr. Groheux. “Based on these findings, 18F-FDG PET/CT may become the single most important distant staging modality in patients with locally advanced breast cancer.”
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LIMIT 188
(41.961669921875): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294744309 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 189
(49.114227294922): SELECT id,name,title
FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1
AND id != 294743300
AND id != 294743301
AND id != 294743302
AND id != 294743303
AND id != 294743304
AND id != 294743305
AND id != 294743306
AND id != 294743307
AND id != 294743308
AND id != 294743309
AND id != 294743310
AND metakey != 'aacc'
ORDER BY `ordering`90
(82.015991210938): SELECT show_live FROM jos_com_show_setting LIMIT 191
(51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 192
(47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 193
(42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 194
(42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 195
(37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 196
(61.03515625): SELECT show_live FROM jos_com_show_setting LIMIT 197
(41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 198
(91.075897216797): SELECT show_live FROM jos_com_show_setting LIMIT 199
(41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1100
(41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1101
(36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1102
(41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1103
(42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1104
(109.19570922852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1105
(73.19450378418): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1106
(82.969665527344): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp
LEFT JOIN jos_experts as exp
ON exp.id = dp.author
LEFT JOIN jos_deeppockets as ch
ON dp.fid = ch.id
WHERE 1=1
AND dp.cat=10
AND dp.id=294744309
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1107
(67.949295043945): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp
LEFT JOIN jos_experts as exp
ON exp.id = dp.author
LEFT JOIN jos_deeppockets as ch
ON dp.fid = ch.id
WHERE 1=1
AND dp.cat=10
AND dp.id=294744309
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1108
(114.91775512695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1109
(62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1110
(72.956085205078): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp
LEFT JOIN jos_experts as exp
ON exp.id = dp.author
LEFT JOIN jos_deeppockets as ch
ON dp.fid = ch.id
WHERE 1=1
AND dp.id=294744309
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1111
(952.00538635254): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp
LEFT JOIN jos_experts as exp
ON exp.id = dp.author
LEFT JOIN jos_deeppockets as ch
ON dp.fid = ch.id
WHERE 1=1
AND dp.id=294744309
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1112
(770.09201049805): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp
LEFT JOIN jos_experts as ex
ON ex.id = dp.author
LEFT JOIN jos_deeppockets as dp2
ON dp2.id = dp.fid
WHERE dp.author != 0
AND dp.cat = 10
AND dp.published = 1
AND (
(dp.fid = 294743300)
OR (dp.fid = 294743301)
OR (dp.fid = 294743302)
OR (dp.fid = 294743303)
OR (dp.fid = 294743304)
OR (dp.fid = 294743305)
OR (dp.fid = 294743306)
OR (dp.fid = 294743307)
OR (dp.fid = 294743308)
OR (dp.fid = 294743309)
OR (dp.fid = 294743310)
)
ORDER BY RAND()
LIMIT 1113
(520.94459533691): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp
LEFT JOIN jos_experts as ex
ON ex.id = dp.author
LEFT JOIN jos_deeppockets as dp2
ON dp2.id = dp.fid
WHERE dp.author != 0
AND dp.cat = 10
AND dp.published = 1
AND (
(dp.fid = 294743300)
OR (dp.fid = 294743301)
OR (dp.fid = 294743302)
OR (dp.fid = 294743303)
OR (dp.fid = 294743304)
OR (dp.fid = 294743305)
OR (dp.fid = 294743306)
OR (dp.fid = 294743307)
OR (dp.fid = 294743308)
OR (dp.fid = 294743309)
OR (dp.fid = 294743310)
)
ORDER BY RAND()
LIMIT 1114
(164.03198242188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1115
(115.87142944336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1116
(88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1117
(95.129013061523): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1118
(84.161758422852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1119
(57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1120
(126.12342834473): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1121
(72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1122
(303.98368835449): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`123
(!!!!! 28052.091598511): SELECT
*
FROM
jos_deeppockets
WHERE
jos_deeppockets.cat = 10
AND
jos_deeppockets.type = 'deeppockets_item'
AND
jos_deeppockets.published = 1
AND
jos_deeppockets.created + INTERVAL 14 DAY >= NOW()
ORDER BY
jos_deeppockets.hits DESC
LIMIT
7124
(614.88151550293): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294744309 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294744309 AND type='deeppockets_item' AND published='1' LIMIT 1125
(!!!!! 9971.8570709229): (
SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.video != ''
AND
dp.video_source != ''
AND
dp.cat = 10
AND
dp.published = 1
AND
dp.type != 'deeppockets_item_link'
ORDER BY
created DESC
LIMIT
3
)
UNION
(
SELECT
dpa.id,
dpa.name,
dpa.title,
dpa.video,
dpa.video_source,
dpa.created
FROM
jos_deeppockets_archive AS dpa
WHERE
dpa.video != ''
AND
dpa.video_source != ''
AND
dpa.cat = 10
AND
dpa.published = 1
AND
dpa.type != 'deeppockets_item_link'
ORDER BY
created DESC
LIMIT
3
)
ORDER BY
created DESC
LIMIT
3126
(144.00482177734): (
SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.video != ''
AND
dp.video_source != ''
AND
dp.cat = 10
AND
dp.published = 1
AND
dp.type != 'deeppockets_item_link'
ORDER BY
created DESC
LIMIT
3
)
UNION
(
SELECT
dpa.id,
dpa.name,
dpa.title,
dpa.video,
dpa.video_source,
dpa.created
FROM
jos_deeppockets_archive AS dpa
WHERE
dpa.video != ''
AND
dpa.video_source != ''
AND
dpa.cat = 10
AND
dpa.published = 1
AND
dpa.type != 'deeppockets_item_link'
ORDER BY
created DESC
LIMIT
3
)
ORDER BY
created DESC
LIMIT
3127
(73.909759521484): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294803337
LIMIT 1128
(41.007995605469): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294803337
LIMIT 1129
(78.916549682617): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294803276
LIMIT 1130
(43.153762817383): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294803276
LIMIT 1131
(308.03680419922): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets_archive AS dp
WHERE
dp.id = 294803276
LIMIT 1132
(56.028366088867): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets_archive AS dp
WHERE
dp.id = 294803276
LIMIT 1133
(85.830688476562): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294802958
LIMIT 1134
(41.961669921875): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294802958
LIMIT 1135
(475.88348388672): SELECT *
FROM jos_deeppockets
WHERE 1=1
AND id=294744309
AND (type='deeppockets_item' OR type='deeppockets_item_link')
AND published='1'
LIMIT 1136
(357.86628723145): SELECT *
FROM jos_deeppockets_archive
WHERE 1=1
AND id=294744309
AND (type='deeppockets_item' OR type='deeppockets_item_link')
AND published='1'
LIMIT 1137
(174.99923706055): SELECT name FROM jos_deeppockets WHERE id=213138
(52.928924560547): SELECT name FROM jos_deeppockets WHERE id=213139
(789.88075256348): SELECT *,
DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up,
DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down
FROM jos_events
WHERE state=1
AND publish_up > NOW()
and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110)
ORDER BY publish_up ASC LIMIT 3140
(705.00373840332): SELECT *,
DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up,
DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down
FROM jos_events
WHERE state=1
AND publish_up > NOW()
and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110)
ORDER BY publish_up ASC LIMIT 3141
(143.05114746094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1142
(81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1143
(!!!!! 11065.006256104): TRUNCATE TABLE jos_trademed_module144
(143.05114746094): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp
LEFT JOIN jos_experts as exp
ON exp.id = dp.author
LEFT JOIN jos_deeppockets as ch
ON dp.fid = ch.id
WHERE 1=1
AND dp.cat=10
AND dp.id=294744309
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1145
(84.161758422852): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp
LEFT JOIN jos_experts as exp
ON exp.id = dp.author
LEFT JOIN jos_deeppockets as ch
ON dp.fid = ch.id
WHERE 1=1
AND dp.cat=10
AND dp.id=294744309
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1146
(602.96058654785): SELECT *
FROM jos_deeppockets
WHERE 1=1
AND id=294744309
AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1147
(119.92454528809): SELECT *
FROM jos_deeppockets
WHERE 1=1
AND id=294744309
AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1148
(97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1149
(63.180923461914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1150
(!!!!! 1642.9424285889): SELECT jos_item.*
FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id
WHERE 1=1
AND (jos_item.imgMini<>'')
AND jos_item.type='L'
AND jos_item.numberID= (
SELECT jos_number.id
FROM jos_number
WHERE jos_number.journalID IN (10)
and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P')
ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC
LIMIT 0,1
)
ORDER BY RAND() DESC LIMIT 6151
(100.85105895996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1152
(66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1153
(55.074691772461): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294744309 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294744309 AND type='deeppockets_item' AND published='1' LIMIT 1154
(42.915344238281): select distinct links.*
from jos_textlinks links
join jos_textlinks_placement placement on links.id=placement.link_id
where journal_id=(10) and (channel_id=213 or channel_id is null)155
(38.14697265625): select distinct links.*
from jos_textlinks links
join jos_textlinks_placement placement on links.id=placement.link_id
where journal_id=(10) and (channel_id=213 or channel_id is null)156
(61.03515625): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1157
(96.08268737793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1158
(63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1'
LIMIT 1159
(57.93571472168): select jos_twitters.link from jos_twitters where cat=10160
(40.054321289062): select jos_facebook.link from jos_facebook where cat=10161
(37.908554077148): select jos_google_plus.link from jos_google_plus where cat=10162
(36.954879760742): select jos_linkedin.link from jos_linkedin where cat=10163
(362.15782165527): update jos_bannersmanager_banner
set impmade=impmade+1
where id in(14615,14202,14203)164
(!!!!! 1245.9754943848): insert into jos_banners_delta values (14615,'2025-09-22 21:16:44','216.73.216.167','view'),(14202,'2025-09-22 21:16:44','216.73.216.167','view'),(14203,'2025-09-22 21:16:44','216.73.216.167','view')
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