When is a PET/CT warranted for breast cancer?

[Gfunk6]

I'm curious what practice patterns are out there. As a general rule, we obtain PET/CTs on all breast cancer patients with clinically node positive disease up front.

What are your indications for such?

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[medgator]

Same. Or if there ends up being pN2/Stage IIIA+ disease post-op (4 or more nodes).

 

[Palex80]

We don't. We perform CT of the thorax and abdomen + bone scan for cN+ / pN+ patients, but PET is not being used in a regular basis for breast cancer.

Are there any data showing a clear advantage of PET vs. CT (with strategy changing implications)? I am aware of data in lung & esophagus, but I am not familiar with any in breast cancer.

 

[medgator]

We don't. We perform CT of the thorax and abdomen + bone scan for cN+ / pN+ patients, but PET is not being used in a regular basis for breast cancer.

Are there any data showing a clear advantage of PET vs. CT (with strategy changing implications)? I am aware of data in lung & esophagus, but I am not familiar with any in breast cancer.

There are some links provided in the NCCN guidelines to back up at least a Category 2B recommendation. The main take home point is that, like in Lung CA, PET/CT may better be able to assess and separate out the true Stage IV patients from others.

Here are a couple links:

http://www.ncbi.nlm.nih.gov/pubmed/20719497
http://www.ncbi.nlm.nih.gov/pubmed/15051773