FDG PET Application for management of breast cancer patient: a narrative review

Background: The application of FDG PET/CT scan for assessment of patientswith breast cancer is increasing. The cost effectiveness of the application could bedifferent in a developing country with limited PET scanners and treatmentpriorities Method: Open discussions of the PET reviewers from ۲ out of ۴ PET centers ofTehran, the capital city of Iran, were organized to provide insight into theiropinions on the indications of FDG PET in breast cancer patients. Results: The sensitivity of FDG PET scan is high for detection of distantmetastases; however, assessment of lymph node pathology and the local extensionof the breast cancer are questionable. Considering the cost of the procedure itselfand the downstream diagnostic procedures, its application and diagnostic accuracyare hindered for breast cancer screening, staging, and assessment of response totreatment and prognosis. The advantages and disadvantages of FDG PET CT anddedicated breast FDG PET scan have been briefed in different clinical scenarioswith a focus on limitations faced by a developing country. Conclusion: We suggest reserving the use of FDG PET for selected cases ofsuspected but not proven recurrent disease and in patients with high risk ofmetastasis before high risk surgery.