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


Cetindag O., Avsar G., Hakseven M., Deryol R., Ertekin S. C., Karasoy D., ...More

EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES, vol.27, no.20, pp.10008-10015, 2023 (SCI-Expanded) identifier identifier identifier

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 relation-ship between lymph node metastasis were eval-uated. 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 ax-illary involvement, while 38 showed axillary in-volvement according to preoperative PET CT. Of the 34 patients with histopathologically con-firmed 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 me-tastasis, 23 had no axillary involvement accord-ing to PET CT, while 10 showed axillary involve-ment. 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 SU-Vmax, can serve as an independent prognostic factor for ALN metastasis in breast cancer pa-tients. Therefore, it may be beneficial for preop-erative risk stratification and personalized treat-ment planning.