A non-invasive, patient-friendly imaging procedure can help doctors make treatment decisions for breast cancer patients when diagnostic questions arise. The 18F-FES PET scan – which was approved by the U.S. Food and Drug Administration in 2020–was proven to resolve the majority of issues, providing physicians with information for individualized treatment decision-making. The study was published in the September issue of The Journal of Nuclear Medicine.
The estrogen receptor (ER) is a major characteristic of breast cancer. It is present in the majority of breast tumors. Hormonal therapy is most likely to be effective for breast tumors that are ER positive. A biopsy of a metastasis or tumor can be used to determine whether there is ER. There are instances where a biopsy may be unsafe or when ER expression is not consistent across tumors.
18F-FES PET is a potential tool to detect the ER expression of all tumors across the body, and may provide useful information about clinical dilemmas in breast cancer patients. In our study, we analyzed whether ER clinical problems could be solved with 18F-FES PET findings.”
Carolina P. Schroder, MD, PhD, medical oncologist, University Medical Center Groningen in The Netherlands
The retrospective study looked at 100 18F-FES PET scans that were carried out on 83 patients who had three types of clinical dilemmas. These included inability to determine the severity or cause of the disease using conventional workup, confusion about ER status and inability to determine which primary tumor caused them.
18FFES PET solved the clinical dilemma in 87 percent of cases. In 93 percent cases that were solved the treatment decision was based on the 18F-FES PET results. The number of solved dilemmas was not related to the type of dilemma. The frequency of solving problems did not correlate with ER status. For example, ER-positive scans had more difficulty solving a dilemma than ER-negative scans.
Schroder said that this was the largest study to show the value of 18FFES PET in an “real daily clinical practice.” “These results suggest the use of 18F-FES PET for optimal patient outcomes and may be a catalyst for the widespread implementation of 18F-FES PET in clinical practice.”
Boers, J., and al. (2021). The value of 18F–FES PET in Solving the clinical dilemmas of Breast Cancer Patients A Retrospective Study. Journal of Nuclear Medicine. doi.org/10.2967/jnumed.120.256826.
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