Diagnostic and Prognostic Value of 18F-FDG PET/CT in Male Breast Cancer: Results From a Bicentric Population

Purpose: We aim to assess the diagnostic and prognostic values of 18Ffluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in a small population with male breast cancer (MBC). Materials and Methods: From May 2005 to Jul 2013, we retrospectively reinterpreted 31 FDG PET/CT scans of 25 men (mean age: 67 years; range: 51-81 years) with a proven breast cancer diagnosis, from two Italian centers. In the majority of patients, an invasive ductal cancer was present (68%). PET/CT scan was performed for initial staging in 5 (16%), restaging in 18 (58%), restaging for the increase of tumor markers in 4 (13%), response to therapy in 2 (6%) and during follow-up in 2 cases (6%). The prognostic impact of PET/CT in this male breast cancer population was assessed by using Kaplan-Meier analysis. Results: Nuclear medicine imaging was negative in 10 subjects while it resulted positive in the residual 15 patients (60%). At initial staging, in four out of five cases, PET/CT showed a significant uptake in the primary cancer and of those three had also a loco-regional lymphatic and distant metastatic involvement. In restaging setting, PET/CT was more accurate than conventional imaging for detection of distant metastases, resolving two false-positive findings. Finally, a positive PET/CT scan was demonstrated to be prognostically unfavorable as compared to a negative exam. Conclusions: MBC is a rare tumor with similar biological and metabolic characteristics of female breast cancer. FDG PET/CT seems to be useful, particularly in the restaging setting, to delineate the correct therapeutic approach and to predict the prognosis.