FDG PET-CT in the management of primary breast lymphoma

Abstract

Objective: Primary breast lymphoma (PBL) is a rare disease and its management differs from other breast cancers. The purpose of this study is to evaluate the role of FDG PET-CT in the management of PBL. We carried out 16 PET-CT scans and reviewed the literature.

Materials and methods: A total of 16 FDG PET-CT scans were done in 8 female patients with PBL with a median age of 49 years (range: 27-68). Of the 16 PET-CT scans, 1 scan was done for primary diagnosis and staging (1 patient), 2 for staging (2 patients), 7 for evaluation of treatment response (6 patients), and 6 for detecting recurrence (4 patients). PET-CT image interpretation and analysis were performed qualitatively (visually) and semiquantitatively using standardized uptake value (SUV). Absence of uptake in the postchemotherapy follow-up PET-CT scan was considered as a complete response, and a fall of more than 50% of baseline SUV was considered as a significant response.

Results: One patient was successfully diagnosed to have PBL and staged using PET-CT. Two patients were correctly staged with the help of FDG PET-CT. Complete response was noted in all 6 patients (3 had a positive baseline scan and showed complete resolution of FDG uptake, the other 3 who did not have baseline PET-CT and lesions were detected on CT, and also showed complete resolution). Of the 4 patients evaluated for recurrence, 1 patient was positive and 3 patients were negative for recurrence in follow-up PET-CT scans done after 18, 22, and 24 months, respectively.

Conclusion: FDG PET-CT has a definitive role in every step of management (diagnosis, staging, treatment response evaluation, and detection of recurrence) in patients with primary breast lymphoma.