Breast Cancer and PET/CT

It's a leading cause of death in women and the most common cancer in women other than skin cancer. This year, 2.6 million American women are living with breast cancer, more than 178,000 women will be diagnosed and more than 43,000 will die. It is the second leading cause of cancer death. And we still don't know how to prevent it or cure it. Early and accurate diagnosis remains a challenge. The current standard relies on physical examination, mammography and/or ultrasound, and fine needle aspiration.

Screening is the most important way to find breast cancer early. To do this, the American Cancer Society recommends that a woman have a:

• Yearly mammogram for women 40 and over
• Clinical breast exam (CBE) yearly for women 40 and over (every 3 years prior to age 40)
• Breast self-examination (BSE) every month (for women over 20)

These screening criteria are set up because the most common sign of breast cancer is a new lump or mass. A lump that is painless, hard, and has irregular edges is more likely to be cancer. It's important to have anything unusual checked by your doctor. Other signs of breast cancer include the following:

• A lump in the underarm area
• A swelling of part of the breast
• Skin irritation or dimpling
• Nipple pain or the nipple turning inward
• A nipple discharge other than breast milk
• Redness or scaliness of the nipple or breast skin

If breast cancer is found early, prompt treatment could save your life.

How Does PET/CT Make a Difference

• PET can show whether or not a lump in the breast is benign or malignant. PET may prove to be a very useful addition to mammography. For 70% of all women with suspicious mammograms, the expense and trauma of a breast biopsy for their final diagnosis may be unnecessary because of PET!
• PET accurately stages axillary and mammary lymph node involvement. Axillary lymph node dissection is currently a routine part of breast surgery, since it is the only way doctors who don't know about PET have of staging breast cancer. A complication of this procedure can be restricted movement of the arm, stiffness, swelling and pain. In the future, a PET scan may make this procedure unnecessary for patients who show no lymph node involvement.
• PET detects distant metastasis resulting in more accurate treatment.
• PET evaluates response to therapy. Treatment can be altered, if necessary, for better results.
• PET shows recurrent disease. Finding recurrent cancer early prolongs your life and increases your chances of beating the disease.

Mammograms are used most commonly to x-ray the breast. During a mammogram, the breast is pressed between two plates for a few seconds while pictures are taken. Although this may cause some discomfort, it is necessary to get a good picture. Very low levels of radiation are used.

The current standard of care relies on physical examination, mammography and/or ultrasound, and fine needle aspiration to diagnose a breast cancer. PET can show whether or not a lump in the breast is benign or malignant. PET may prove to be a very useful addition to mammography.

For 70% of all women with suspicious mammograms, the expense and trauma of a breast biopsy for their final diagnosis may be unnecessary. Specifically, patients with breast implants, dense breasts, and others may benefit from having a PET scan to help look for a lesion in the breast.

(1) Source: Clinical Positron Imaging Journal, the official Journal of the Academy of Molecular Imaging, Vol 3, Number 5, Sept-Oct 2000.

The doctors diagnose the cancer and determine what kind it is by looking at a sample of the tumor under a microscope. This alone does not determine what treatment you can have. Before you have treatment, your doctors must determine if or how much the breast cancer has spread. This is called staging the cancer.

Treatment options, including whether surgery, radiation therapy, or chemotherapy is the best option, as well as the outlook for your recovery depends on the stage of the cancer. If breast cancer is found and treated before it has spread to lymph nodes or other organs, the five-year survival rate is extremely high - about 98 percent. Early diagnosis and treatment is critical in conquering breast cancer.

Disease Staging

PET is the most useful test that you can have when doctors are staging or re-staging breast cancer because it is more accurate any other test in finding local or distant disease. Although PET cannot see microscopic disease, it can detect clusters of tumor cells that have taken hold in other tissues or organs in the body.

Other resources for patients with breast cancer

Academy of Molecular Imaging's World of PET
American Cancer Society
Breast Cancer Research Foundation
Living Beyond Breast Cancer
Medline Plus Breast Cancer
National Alliance of Breast Cancer Organizations
National Breast Cancer Foundation
National Cancer Institute
National Coalition for Cancer Survivorship
Sisters Network
Susan G. Komen Breast Cancer Foundation
Y-ME National Breast Cancer Organization
YWCA Encore Plus Program