Full size image available through contact |
Reston, VA….A PET scan changed the clinical management of 60% of women with recurrent breast cancer. It also changed the cancer staging for 36% of those scanned, according to a new survey of referring physicians published September 4 in The Journal of Nuclear Medicine.
Results for 50 patients with breast cancer were reported by 32 different physicians. Clinical management changes included moving from one type of treatment to another, that is, i.e., from surgery to radiation therapy, or from medical treatment to no treatment. Other changes were within the existing treatment, i.e., changing from one kind of chemotherapy to another. The impact of the PET scan results was also significant on disease staging. More than a quarter (28%; n = 14) were upstaged and 8% (n = 4) were downstaged. Before the scan, 36% of the patients were reported as having stage IV cancer; after the scan, more than half (52%) were at this level as a result of finding previously undetected metastases.
“These results demonstrate the importance of PET in making treatment decisions for women with recurrent breast cancer,” stated study author Johannes Czernin, MD, of the Department of Molecular and Medical Pharmacology, Ahmanson Biological Imaging Clinic/Nuclear Medicine Clinic, University of California, Los Angeles (UCLA). “Better treatment decisions should mean longer and better quality of life for those suffering from this disease.”
All of the patients referred for PET scans had been sent for restaging. Czernin noted that even when staging itself wasn’t affected, physicians often changed the clinical management as a result of the scan, adding to its importance.
“This study, combined with the Medicare Coverage Advisory Committee’s June 19 vote in favor of reimbursement for recurrent breast cancer, reinforces the role and the importance of PET in the disease management and treatment planning of women with breast cancer,” Czernin stated.
The American Cancer Society (ACS) estimates that there will be approximately 193,706 new cases of invasive breast cancer in 2001 among women in the United States and about 40,600 deaths from the disease. According to the ACS, declining death rates “are probably the result of earlier detection and improved treatment.”
The survey was conducted at the Ahmanson Biological Imaging Clinic of UCLA and the Northern California PET Imaging Center (NCPIC), the facilities to which the patients were referred for their scans.
“Impact of Whole-Body FDG PET on Staging and Managing Patients with Breast Cancer: The Referring Physician’s Perspective,” was written by Cecelia S. Yap, Marc A. Seltzer, Christiaan Schiepers, Sanjiv S. Gambhir, Jyotsna Rao, Michael E. Phelps, Peter E. Valk, and Johannes Czernin of the Department of Molecular and Medical Pharmacology, Ahmanson Biological Imaging Clinic/Nuclear Medicine Clinic, UCLA School of Medicine, Los Angeles, California, and the NCPIC, Sacramento, California. The referring physicians of 160 breast cancer patients who underwent whole-body FDG PET at Ahmanson and the NCPIC were surveyed. Thirty-two referring physicians for 50 patients returned the completed, two-stage survey.
PET measures the body’s metabolic activity. A patient undergoing a PET scan is injected with the radiopharmaceutical fluorodeoxyglucose, FDG, about 45 minutes before the scan. The radiopharmaceutical tracer emits signals that are picked up by the PET scanner. A computer reassembles the signals into images that display the distribution of metabolic activity as an anatomic image. Areas in which cancer is present will show up more brightly on the scan because the disease is more metabolically active than non-cancerous cells.
The Society of Nuclear Medicine (SNM), which publishes The Journal of Nuclear Medicine, has over 13,000 members and is an international scientific and professional organization dedicated to promoting the science, technology, and practical application of nuclear medicine. SNM is based in Reston, Virginia. For more information, visit the SNM Web site at www.snm.org.
Copies of the article and images related to the study are available to media upon request to Karen Lubieniecki at Karenlub@aol.com; 703-683-0357. Copies of this and past issues of The Journal of Nuclear Medicine are available online at jnm.snmjournals.org. Print copies can be obtained at $15 per copy by contacting the SNM Service Center, Society of Nuclear Medicine, 1850 Samuel Morse Drive, Reston, VA 20190-5315; phone: 703-326-1186; fax: 703-708-9015; e-mail: servicecenter@snm.org. A yearly subscription to the journal is $170. A journal subscription is a member benefit of the Society of Nuclear Medicine.
Journal
Journal of Nuclear Medicine