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Utility of Second-Look Examinations in the Management of a New Hypermetabolic Lesion Detected by Fluorodeoxyglucose Positron Emission Tomography/CT for Diagnosis of Loco-Regional Recurrence in Patients with Breast Cancer
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Abstract
¸ñÀû: À¯¹æ¾Ï ¼ö¼úÀ» ¹ÞÀº ȯÀÚÀÇ ±¹¼Ò Áö¿ª¼º Àç¹ßÀÇ Áø´Ü¿¡ ÀÖ¾î¼ fluorodeoxyglucose positron emission tomography (ÀÌÇÏ FDG-PET)/CT¿¡¼ »õ·Ó°Ô ¹ß°ßµÈ °ú´ë»ç º´º¯ÀÇ ÀÓ»óÀû ÀÇÀÇ¿Í ÀÌ¿¡ ´ëÇÑ 2Â÷ °Ë»çÀÇ À¯¿ë¼ºÀ» ¾Ë¾Æº¸°íÀÚ ÇÑ´Ù.
´ë»ó°ú ¹æ¹ý: 2008³â 1¿ùºÎÅÍ 2011³â 7¿ù±îÁö ¼ö¼úÀû Ä¡·á¸¦ ¹ÞÀº 922¸íÀÇ À¯¹æ¾Ï ȯÀÚ Áß Á¤±â ÃßÀû°Ë»ç¿¡¼ Ưº°ÇÑ ÀÌ»óÀÌ ¾ø¾úÁö¸¸ FDG-PET/CT»ó ±¹¼Ò Áö¿ª¿¡ »õ·Ó°Ô °ú´ë»ç º´º¯ÀÌ ¹ß°ßµÈ 20¸íÀÇ ¿µ»óÀ» ºÐ¼®ÇÏ¿´´Ù. ¸ðµç ȯÀÚ´Â °ú´ë»ç º´º¯¿¡ ´ëÇÑ 2Â÷ °Ë»ç(ÃÊÀ½ÆÄ = 14, ÈäºÎ Àü»êÈ´ÜÃþÃÔ¿µ = 6)¸¦ ½ÃÇàÇÏ¿´´Ù. 17¸íÀº Á¶Á÷ÇÐÀûÀ¸·Î, 3¸íÀº ¿µ»óÀÇÇÐÀû ÃßÀû°üÂûÀ» ÅëÇØ Áø´ÜµÇ¾ú´Ù.
°á°ú: °ú´ë»ç º´º¯ÀÌ ¹ß°ßµÈ À§Ä¡´Â ¾×¿ÍºÎ ¸²ÇÁÀý(n = 7), À¯¹æ½ÇÁú(n = 6), È亮(n = 3), °æºÎ ¸²ÇÁÀý(n = 3), ¼Ó°¡½¿ ¸²ÇÁÀý(n = 1)À̾ú´Ù. »õ·Ó°Ô °¨ÁöµÈ °ú´ë»ç º´º¯ 20¿¹ Áß 10¿¹°¡ Á¶Á÷°Ë»ç»ó ¾Ç¼ºÀ¸·Î Áø´ÜµÇ¾ú´Ù. ÃÊÀ½ÆÄ¿¡¼ 7¿¹´Â ¾Ç¼ºÀÌ ÀǽɵǾú°í ÀÌ Áß 5¿¹°¡ Á¶Á÷ÇÐÀûÀ¸·Î ¾Ç¼ºÀ̾ú´Ù. ÈäºÎ Àü»êÈ´ÜÃþÃÔ¿µÀ» ½Ç½ÃÇÑ 6¸íÀÇ °æ¿ì 5¿¹°¡ ¾Ç¼ºÀÌ ÀǽɵǾúÀ¸¸ç ¸ðµÎ Á¶Á÷ÇÐÀûÀ¸·Î ¾Ç¼ºÀ̾ú´Ù. 2Â÷ °Ë»ç¿¡¼ ¾Ç¼ºÀÌ ÀÇ½ÉµÈ ¿¹ÀÇ 83.3%(10/12)°¡ Á¶Á÷°Ë»ç»ó ¾Ç¼ºÀ̾ú´Ù.
°á·Ð: À¯¹æ¾Ï ȯÀÚÀÇ Á¤±â ÃßÀû°Ë»ç Áß FDG-PET/CT¿¡¼ »õ·Ó°Ô ¹ß°ßµÈ °ú´ë»ç º´º¯Àº ±¹¼ÒÀç¹ßÀÇ °¡´É¼ºÀÌ ³ôÀ¸¸ç µû¶ó¼ ÀÌ¿¡ ´ëÇÑ Àû±ØÀûÀÎ 2Â÷ °Ë»ç¿Í ÇÊ¿äÇÑ °æ¿ì¿¡ Ãß°¡ÀûÀÎ Á¶Á÷°Ë»ç¸¦ ½ÃÇàÇÏ¿©¾ß ÇÑ´Ù.
Purpose: To investigate the clinical significance of a new hypermetabolic lesion detected by fluorodeoxyglucose positron emission tomography/CT (FDG-PET/CT) as well as the utility of second-look examinations to evaluate loco-regional recurrence of breast cancer.
Materials and Methods: Our database revealed 922 breast cancer patients who underwent surgery from January 2008 to July 2011. We included 20 patients with negative findings on routine follow-up but with new hypermetabolic lesions on FDG-PET/CT. All underwent second-look examination [breast ultrasound (US) = 14, chest CT scan = 6]. A total of 17 cases were pathologically verified and 3 were diagnosed with follow-up imaging.
Results: The locations were in the axillae (n = 7), breast (n = 6), chest wall (n = 3), cervical/supraclavicular (n = 3), and internal mammary (n = 1). Of the 20 hypermetabolic lesions, 10 were pathologically confirmed malignancies. Of the 14 patients who had undergone US, 7 had suspicious findings and 5 were confirmed as malignancies. Of a total of 6 patients who had undergone CT scans, 5 had suspicious findings and all turned out to be malignancies. The positive predictive value of the second-look examination was 83.3% (10/12).
Conclusion: Second-look examination and pathologic confirmation should be performed for newly appearing hypermetabolic lesions on FDG-PET/CT in order to exclude loco-regional recurrence in breast cancer patients.
Å°¿öµå
Breast Cancer, Fluorodeoxyglucose Positron Emission Tomography/CT, Recurrence, Second-Look Ultrasound
KMID :
1103720140700020145
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