Impact of whole-body F-18-FDG PET on staging and managing patients with breast cancer: The referring physician's perspective

FDG PET has emerged as an important clinical imaging modality for diagnosin g and staging cancer. However, the impact of FDG PET on staging and managin g patients with breast cancer from the referring physician's point of view is unknown. Methods: The referring physicians of 160 breast cancer patients received standardized questionnaires inquiring if and how PET findings alt ered their patient's stage and their clinical management decisions. Managem ent changes were classified as intermodality if the change was from one mod ality to another (e.g., medical to surgical, surgical to radiation, medical to no treatment, and vice versa) or as intramodality if the change was wit hin the same modality (e.g., altered medical or radiotherapy approach). Res ults: Fifty of the 160 surveys were completed (31% response rate). PET chan ged the clinical stage in 36% of patients (28% upstaged, 8% downstaged) and resulted in intermodality changes in 28% of patients and intramodality cha nges in 30% of patients. Conclusion: The results of this prospective survey show that FDG PET has a major impact on the management of breast cancer pa tients, influencing both clinical stage and management in more than 30% of patients.