Combined PET/MRI Improves Treatment Decisions in Early Breast Cancer

FRIDAY, March 29, 2024 (HealthDay News) -- Combined positron emission tomography and magnetic resonance imaging (PET/MRI) has potential utility in the management of patients with early breast cancer, according to a study presented at the annual European Breast Cancer Conference, held from March 20 to 22 in Milan.

Rosa Di Micco, M.R.B.S., Ph.D., from IRCCS San Raffaele University and Research Hospital in Milan, and colleagues evaluated the impact of fluorodeoxyglucose PET/MRI at diagnosis on breast cancer management among 205 patients who were candidates for primary surgery.

The researchers found that PET/MRI substantially influenced treatment strategies in 27.8 percent of patients, leading to modification in clinical recommendation. These changes included primary systemic therapy or systemic therapy for metastatic or other diseases (18 patients); mastectomy instead of previously planned breast-conserving surgery (BCS; nine patients); axillary dissection or node sampling instead of sentinel node biopsy (12 patients); bilateral surgery (12 patients); and oncoplastic remodeling instead of standard BCS (six patients). Pathology showed that in 12 of these patients (21 percent), additional lesions seen on PET/MRI were not malignant. Overall, PET/MRI had a positive predictive value of 58.3 percent for detecting new foci of disease in the same breast and 45.5 percent in the contralateral breast. For visualizing multifocal breast cancer, its sensitivity was 68.4 percent and specificity was 88.9 percent. Among the 55 newly detected lesions at different sites, 37 warranted further tests (e.g., computed tomography scans, X-rays, ultrasounds, or biopsy), and this led to three diagnoses of metastatic disease, one lung cancer diagnosis, and diagnosis of 11 benign tumors and 10 benign conditions.

"Our research suggests that for patients with early breast cancer, the addition of a PET/MRI scan to standard care could help us make more informed decisions about the best treatment pathway," Di Micco said in a statement. "However, results of this technique are still affected by a high percentage of false positives and should therefore be confirmed by further testing."

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