The predictive value, sensitivity, specificity, and accuracy of PET CT in the evaluation of axillary metastases in breast cancer

Abstract

Objective: This study aims to evaluate the accuracy of preoperative 18F-FDG PET CT in detecting axillary lymph node (ALN) metastases in patients with breast cancer.

Patients and methods: A retrospective analysis was performed on the medical records of 114 patients who underwent PET CT for breast cancer between January 2017 and January 2020. Clinicopathological features and the relationship between lymph node metastasis were evaluated. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated based on the PET CT findings compared to histopathological results.

Results: Among the 67 patients included in this study, 29 were identified as having no axillary involvement, while 38 showed axillary involvement according to preoperative PET CT. Of the 34 patients with histopathologically confirmed metastatic lymph nodes, 28 had PET CT-detected axillary involvement, while 6 did not. Similarly, among the 33 patients without histopathological evidence of lymph node metastasis, 23 had no axillary involvement according to PET CT, while 10 showed axillary involvement. The calculated values were as follows: sensitivity = 82.4% (67-92%), specificity = 69.7% (53-83%), positive predictive value = 73.7% (62-83%), negative predictive value = 79.3% (64%-89%), and accuracy = 76.1% (64-86%).

Conclusions: The results suggest that preoperative 18F-FDG PET CT, particularly p SUVmax, can serve as an independent prognostic factor for ALN metastasis in breast cancer patients. Therefore, it may be beneficial for preoperative risk stratification and personalized treatment planning.