A biopsy is the standard for measuring hormone sensitivity, but it cannot always be performed safely. During a biopsy, a piece of tissue is removed for examination. The fact that the FES-PET scan appears to be a patient-friendly alternative for determining ‘the ER’ is important for thousands of women each year who are diagnosed with metastatic breast cancer.
The research was carried out by multidisciplinary teams with five Dutch centers: the UMCG in Groningen, Amsterdam UMC, location VUmc, UMC Utrecht, Erasmus MC in Rotterdam and Radboudumc in Nijmegen. It was made possible with KWF funding and the results of the study have been published in the Journal of Clinical Oncology.
Patients would rather have a scan than a biopsy
‘A biopsy provides more information than just about the ER, and will therefore remain relevant,’ explains. internist-oncologist Schröder on the website from UMCG. “But if a biopsy is not safe to perform, the FES-PET scan is an excellent alternative to determine hormone sensitivity of metastatic breast cancer. This is directly important for daily practice. In addition, we know that patients prefer a scan to a biopsy. The aim is therefore to make the FES-PET scan as widely available as possible and to include it in guidelines.”
To map possible metastases of breast cancer, tests and scans are performed on patients. This includes, for example, a standard CT scan, FDG PET scan or bone scan and a biopsy of a metastasis. A biopsy is very important to determine the characteristics, such as presence of the ER, of the breast cancer. The ER is present in about 70% of all breast cancers who with that information are sensitive to hormone treatments. It is important to reassess these characteristics with metastases, as they can change over time. The Dutch IMPACT study examined whether adding specific PET scans, such as the FES-PET scan, to the standard studies was useful.
Reliable results
The answer that emerges from the survey is unequivocally ‘yes’. The current study shows that with FES-PET uptake above a certain limit (maximal standard uptake value > 2.5), the biopsy also shows ER in 99% of the cases. The current research shows that with FES-PET uptake above a certain limit, the biopsy also shows ER in 99% of the cases. The FES-PET scan is therefore very reliable.
The study was conducted with five Dutch centers. Schröder: ‘This allowed us to put together the largest cohort of patients with recently metastatic breast cancer. Moreover, by conducting the research with these centers, all protocols for specific scans, biopsies and other procedures were aligned. This provides a wealth of information, which ultimately helps to predict as accurately as possible which person will respond to which therapy. Hopefully this will further improve the prospects for women with metastatic breast cancer in the future.’
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