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FDG-PET/CT Imaging Helpful for Breast Cancer Patients Younger Than Forty

By MedImaging International staff writers
Posted on 15 Oct 2014

Positron emission tomography/computed tomography (PET/CT) imaging of patients younger than 40 who were first diagnosed with stage I–III breast cancer resulted in a change of diagnosis, new findings showed.

Researchers from Memorial Sloan Kettering (New York, NY, USA) discovered that PET/CT imaging of patients younger than 40 who were initially diagnosed with stage I-III breast cancer resulted in change of diagnosis. As reported in the October 2014 issue of the Journal of Nuclear Medicine, while guidelines recommend FDG-PET/CT imaging only for women with stage III breast cancer, it can also help physicians more effectively diagnose young breast cancer patients initially diagnosed with earlier stages of the disease.

Assessing if and how far breast cancer has metastasized throughout the body is what physician’s refer to as staging. Most women now are diagnosed at earlier stages, meaning stage 1 or 2 of possible 4 stages, according to the researchers. Current US Comprehensive Cancer Network (NCCN) guidelines consider systemic FDG-PET/CT staging for only stage III breast cancer patients. More recently it has been debated whether factors other than stage should be considered in this decision. One such factor is patient age, as young breast cancer patients often have more aggressive tumors. In this study, researchers from Memorial Sloan Kettering Cancer Center in New York evaluated for the first time the impact of FDG PET/CT staging specifically in a young patient cohort. The study suggests that breast cancer patients under the age of 40 may benefit from systemic staging with FDG PET/CT at earlier stages than NCCN guidelines suggest.

“Proper staging right after the breast cancer has first been diagnosed will help doctors make the right treatment decisions. And figuring out which breast cancer patients will benefit most from this ‘advanced staging’ with FDG PET/CT helps us to improve patient care while avoiding unnecessary tests,” stated Christopher Riedl, MD, one of the team's lead researchers. "Our data suggest that women younger than 40 may benefit from PET/CT staging at earlier stages than doctors previously believed.”

The study included 134 patients with initial diagnoses of stage I to IIIC breast cancer; those with signs of distant metastases or with prior malignancy were excluded. PET/CT findings lead to upstaging to stage III or IV in 28 patients (21%). Unsuspected extra-axillary regional nodes were found in 15/134 (11%) and distant metastases in 20/134 (15%), with 7/134 (5%) demonstrating both. PET/CT revealed stage IV disease in 1/20 (5%) patients with initial clinical stage I, 2/44 (5%) stage IIA, 8 /47 (17%) stage IIB, 4/13 (31%) stage IIIA, 4/8 (50%) of IIIB, and 1/2 (50%) of stage IIIC patients. All 20 patients upstaged to stage IV were histologically validated. One rectal and four synchronous thyroid malignancies were identified.

“Future NCCN guidelines for initial staging of breast cancer patients may need to consider other factors in addition to clinical stage. This study provides further evidence that molecular imaging and nuclear medicine can help us make better cancer staging and treatment decisions,” said Gary Ulaner, MD, PhD, assistant professor at Memorial Sloan Kettering. “Of course, our findings should still be confirmed in a prospective trial. Our next step will be to look at factors other than patient age to understand which breast cancer patients benefit most from FDG-PET/CT.”

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66 (29.087066650391): select jos_google_plus.link from jos_google_plus where cat=10

67 (26.941299438477): select jos_linkedin.link from jos_linkedin where cat=10

68 (38.14697265625): SELECT fid FROM jos_deeppockets WHERE id=294755104 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294755104 AND published='1' LIMIT 1

69 (31.948089599609): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

70 (!!!!! 7001.8768310547): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294755104 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (451.08795166016): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294755104 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (49.829483032227): 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`

73 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (55.074691772461): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294755104 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (29.087066650391): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294755104 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (33.855438232422): 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 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (!!!!! 1381.1588287354): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 1496.0765838623): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

105 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

106 (207.90100097656): 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=294755104 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (116.10984802246): 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=294755104 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 6917.9534912109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

109 (!!!!! 2130.9852600098): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

110 (!!!!! 1024.0077972412): 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=294755104 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (756.02531433105): 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=294755104 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (800.13275146484): 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 1

113 (378.13186645508): 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 1

114 (699.04327392578): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

115 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

116 (132.08389282227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

117 (113.01040649414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

118 (!!!!! 1196.8612670898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

119 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

120 (420.09353637695): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 34912.824630737): 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 7

122 (127.07710266113): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

123 (138.0443572998): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

124 (559.09156799316): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294755104 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294755104 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1402093.1720734): ( 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 3

126 (!!!!! 2176434.9937439): ( 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 3

127 (284.91020202637): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (190.97328186035): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (115.15617370605): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (66.041946411133): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (62.942504882812): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (28.848648071289): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (412.94097900391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (401.97372436523): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (61.03515625): SELECT name FROM jos_deeppockets WHERE id=213

136 (27.894973754883): SELECT name FROM jos_deeppockets WHERE id=213

137 (452.04162597656): 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 3

138 (444.17381286621): 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 3

139 (!!!!! 1006.8416595459): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

140 (144.95849609375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

141 (!!!!! 10471.105575562): TRUNCATE TABLE jos_trademed_module

142 (186.20491027832): 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=294755104 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (714.06364440918): 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=294755104 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (998.97384643555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (59.843063354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

147 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

148 (!!!!! 1055.0022125244): 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 6

149 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

150 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

151 (!!!!! 3277.063369751): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294755104 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294755104 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (61.03515625): 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)

153 (!!!!! 2771.1391448975): 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)

154 (55.074691772461): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (203.84788513184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

156 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755104 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755104 AND published='1' LIMIT 1

157 (71.048736572266): select jos_twitters.link from jos_twitters where cat=10

158 (27.179718017578): select jos_facebook.link from jos_facebook where cat=10

159 (46.968460083008): select jos_google_plus.link from jos_google_plus where cat=10

160 (46.014785766602): select jos_linkedin.link from jos_linkedin where cat=10

161 (317.81196594238): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 13884.0675354): insert into jos_banners_delta values (14615,'2025-05-02 11:45:19','18.189.188.228','view'),(14202,'2025-05-02 11:45:19','18.189.188.228','view'),(14203,'2025-05-02 11:45:19','18.189.188.228','view')

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