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Summary:
A 71 year old female with a history of breast cancer was referred for a PET scan. Previously the patient was diagnosed by a surgical excision 11/11/2002. Histopathology demonstrated ductal carcinoma with one positive right axillary lymph node. Thoracic spine films dated 12/06/02 showed a compression fracture on the lower thoracic or upper lumbar spine. PET scan was requested for staging the disease. No previous CT’s, x-rays or MRI were available on this patient.
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Imaging Parameters:
12 mCi 18-Fluorodeoxyglucose(FDG) injected approximately 1-2 hours prior to scanning. Patient must uptake quietly during this time and void prior to imaging. A non-diagnostic CT scan was performed for anatomic localization and attenuation correction. The CT was followed by a whole body PET scan (6-7 bed positions).
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Findings:
Residual cancer in right breast, metastatic disease to right axillary nodes, metastatic disease to right internal mammary nodes. Of note, there was no uptake of 18FDG in the spine. Repeat bone scan was recommended.
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Discussion:
Early diagnosis and treatment are key to cure rates in Breast Cancers. Imaging with 18FDG is an important part of diagnosis, primary staging, recurrence, and monitoring the effectiveness of treatments. Although mammography has helped to detect breast cancer in many women, cancers are missed in women with dense breast tissue, implants or have been previously treated for breast cancer.
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Images courtesy of:
Georgia Cancer Center
Grady Memorial Center for Excellence
Atlanta, GA
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