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The Prognostic Value of 18F-FDG Uptake in the Supraclavicular Lymph Node (N3c) on PET/CT in Patients With Locally Advanced Breast Cancer With Clinical N3c

 Lee, Suk Hyun  ;  Kim, Sung Hoon  ;  Park, Hyung Seok  ;  Kim, Joo Heung  ;  Kim, Dongwoo  ;  Cho, Hojin  ;  Yun, Mijin 
 CLINICAL NUCLEAR MEDICINE, Vol.44(1) : e6-e12, 2019 
Journal Title
Issue Date
Biological Transport ; Breast Neoplasms/diagnostic imaging* ; Breast Neoplasms/metabolism* ; Breast Neoplasms/pathology ; Disease-Free Survival ; Female ; Fluorodeoxyglucose F18/metabolism* ; Humans ; Lymph Nodes/metabolism* ; Lymph Nodes/pathology ; Lymphatic Metastasis ; Middle Aged ; Positron Emission Tomography Computed Tomography* ; Retrospective Studies
PURPOSE: We investigated the prognostic value of F-FDG uptake in the supraclavicular lymph node (SCLN) on PET/CT in breast cancer patients with clinical ipsilateral SCLN metastasis (cN3c). METHODS: Fifty-five female patients with initial F-FDG PET/CT were treated with curative intent. For semiquantitative analysis, the SUVmax of the primary tumor, axillary lymph node, and SCLN were normalized by the SUVmean of the liver (defined as SUVR-tumor, SUVR-axillary lymph node, and SUVR-SCLN, respectively). Cox proportional hazards models were used to predict disease-free survival (DFS) and overall survival (OS). Differences in DFS and OS were assessed by Kaplan-Meier analysis. RESULTS: Twenty-three patients (41.8%) experienced recurrence, and 13 (23.6%) died during follow-up (median, 70.0 months; range, 6-128 months). In multivariate analysis, SUVR-tumor greater than 3.26 (hazards ratio, 7.26; 95% confidence interval, 1.58-33.31; P = 0.01) and SUVR-SCLN greater than 1.05 (hazards ratio, 8.47; 95% confidence interval, 1.09-65.87; P = 0.04) were prognostic for OS. No clinicopathologic or PET/CT parameters were prognostic for DFS. The patients were divided into 3 groups: group 1 (n = 11, SUVR-tumor ≤3.26 and SUVR-SCLN ≤1.05); group 2 (n = 27, SUVR-tumor >3.26 or SUVR-SCLN >1.05); and group 3 (n = 17, SUVR-tumor >3.26 and SUVR-SCLN >1.05). The 5-year OS rates were 100% in group 1, 85.2% in group 2, and 51.0% in group 3. Group 3 showed worse prognosis than group 1 (P < 0.01) and group 2 (P < 0.01). CONCLUSIONS: In addition to SUVR-tumor, SUVR-SCLN seemed to play an important role in selecting patients with the worst prognosis.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dongwoo(김동우) ORCID logo https://orcid.org/0000-0002-1723-604X
Kim, Joo Heung(김주흥)
Park, Hyung Seok(박형석) ORCID logo https://orcid.org/0000-0001-5322-6036
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Cho, Hojin(조호진) ORCID logo https://orcid.org/0000-0002-8686-172X
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