Breast Cancer Systemic Staging (Comparison of Computed Tomography, Bone Scan, and 18F-Fluorodeoxyglucose PET/Computed Tomography)

Abstract

After an overview of the principles of bone scintigraphy, contrast-enhanced computed tomography (CE-CT) and 18F-fluorodeoxyglucose (FDG)-PET/CT, the advantages and limits of these modalities in the staging of breast cancer are discussed in this paper. CT and PET/CT are not optimal for delineating primary tumor volume, and PET is less efficient than the sentinel node biopsy to depict small axillary lymph node metastases. In large breast cancer tumor, FDG PET/CT is useful to show extra-axillary lymph nodes. FDG PET/CT is superior to bone scan and CE-CT in detecting distant metastases, and it results in a change of treatment plan in nearly 15% of patients.

Keywords: Bone scan; Bone scintigraphy; Breast cancer; CE-CT; FDG; Initial workup; PET/CT; Staging.