The predictive value of incidental PET/CT findings suspicious for breast cancer in women with non-breast malignancies

Beatty, John S.; Williams, Hadyn T.; Gucwa, Angela L.; Hughes, Matthew P.; Vasudeva, Viren S.; Aldridge, Beau A.; Fields, Deborah M.; David, George S.; Lind, D. Scott; Kruse, E. James; McLoughlin, James M.

doi:10.1016/j.amjsurg.2009.06.009

« Previous Next »The American Journal of Surgery
Volume 198, Issue 4 , Pages 495-499, October 2009

The predictive value of incidental PET/CT findings suspicious for breast cancer in women with non-breast malignancies

John S. Beatty, M.D.
- Department of Surgery, Medical College of Georgia, Augusta, GA, USA
Hadyn T. Williams, M.D.
- Department of Radiology, Medical College of Georgia, Augusta, GA, USA
Angela L. Gucwa, M.D.
- Department of Surgery, Medical College of Georgia, Augusta, GA, USA
Matthew P. Hughes, B.S.
- School of Medicine, Medical College of Georgia, Augusta, GA, USA
Viren S. Vasudeva, B.A.
- School of Medicine, Medical College of Georgia, Augusta, GA, USA
Beau A. Aldridge, B.S.
- School of Medicine, Medical College of Georgia, Augusta, GA, USA
Deborah M. Fields, C.N.M.T., M.Ed.
- Department of Radiology, Medical College of Georgia, Augusta, GA, USA
George S. David, M.S.
- Department of Radiology, Medical College of Georgia, Augusta, GA, USA
D. Scott Lind, M.D.
- Department of Surgery, Medical College of Georgia, Augusta, GA, USA
E. James Kruse, D.O.
- Department of Surgery, Medical College of Georgia, Augusta, GA, USA
James M. McLoughlin, M.D.
- Department of Surgery, Medical College of Georgia, Augusta, GA, USA
- Corresponding author. Tel.: 706-721-4728; fax: 706-721-9136

Received 24 March 2009; received in revised form 14 June 2009

Abstract

Background

On occasion, patients followed with positron emission tomographic (PET)/computed tomographic (CT) imaging for nonbreast malignancies will have incidental breast findings concerning for second primary breast cancers. The aim of this study was to determine the predictive value of PET/CT imaging to identify breast cancers in these patients.

Methods

Patients with primary nonbreast malignancies and findings concerning for second primary breast cancers were identified from a prospectively acquired nuclear medicine database from January 2005 to July 2008. Chart reviews were then performed.

Results

Nine hundred two women underwent PET/CT imaging to evaluate nonbreast malignancies. Nine women (1%) had concerning breast findings, and 5 (56%) had subsequent breast cancer diagnoses. The positive predictive value of PET/CT imaging in these patients was 63%. Evidence of compliance with current screening guidelines was present in only 22% of these patients.

Conclusions

The data suggest that findings concerning for an additional primary breast cancer should be evaluated and that age-appropriate screening tools should not be abandoned.

Keywords: PET/CT, Breast cancer, Second primary malignancy