Given that 8% to 14% of women with locally advanced breast cancer have distant metastatic disease at diagnosis (beyond the axillary nodes), FDG-PET/CT skull base to mid-thigh may be preferred over conventional CT imaging [130]. In addition, several studies have shown FDG-PET/CT to be superior in detecting internal mammary and mediastinal lymphadenopathy [129] but inferior to contrast-enhanced chest CT at detecting pulmonary metastases [130]. Multiple studies show that PET/CT staging is more useful for stage IIIB and operable stage IIIA tumors and specific tumor subtypes including invasive ductal cancers, ER-negative and triple-negative tumors, high-grade malignancies, and those with p53 mutations [131-133]. PET/CT staging is not as useful for low-grade malignancies or invasive lobular cancers because of the overall low isotope uptake [134]. MRI Chest, Abdomen, Pelvis Without and With IV Contrast There is no relevant literature to support the use of MRI chest, abdomen, and pelvis without and with IV contrast in the initial evaluation of metastatic disease. 13 Monitoring Response to Neoadjuvant Chemotherapy MRI Chest, Abdomen, Pelvis Without IV Contrast There is no relevant literature to support the use of MRI chest, abdomen, and pelvis without IV contrast in the initial evaluation of metastatic disease. Variant 7: Adult female or male or transfeminine (male-to-female) or transmasculine (female-to-male). Known axillary lymph node-positive breast cancer on prior mammography, US, or MRI. Axillary evaluation after completion of neoadjuvant chemotherapy, axilla previously evaluated. Next imaging study. Digital Breast Tomosynthesis Diagnostic Although many patients undergo mammography or DBT after NAC, there is no specific evidence supporting its use in the imaging of known axillary lymph node-positive breast cancer after completion of therapy.
Monitoring Response to Neoadjuvant Systemic Therapy for Breast Cancer. Given that 8% to 14% of women with locally advanced breast cancer have distant metastatic disease at diagnosis (beyond the axillary nodes), FDG-PET/CT skull base to mid-thigh may be preferred over conventional CT imaging [130]. In addition, several studies have shown FDG-PET/CT to be superior in detecting internal mammary and mediastinal lymphadenopathy [129] but inferior to contrast-enhanced chest CT at detecting pulmonary metastases [130]. Multiple studies show that PET/CT staging is more useful for stage IIIB and operable stage IIIA tumors and specific tumor subtypes including invasive ductal cancers, ER-negative and triple-negative tumors, high-grade malignancies, and those with p53 mutations [131-133]. PET/CT staging is not as useful for low-grade malignancies or invasive lobular cancers because of the overall low isotope uptake [134]. MRI Chest, Abdomen, Pelvis Without and With IV Contrast There is no relevant literature to support the use of MRI chest, abdomen, and pelvis without and with IV contrast in the initial evaluation of metastatic disease. 13 Monitoring Response to Neoadjuvant Chemotherapy MRI Chest, Abdomen, Pelvis Without IV Contrast There is no relevant literature to support the use of MRI chest, abdomen, and pelvis without IV contrast in the initial evaluation of metastatic disease. Variant 7: Adult female or male or transfeminine (male-to-female) or transmasculine (female-to-male). Known axillary lymph node-positive breast cancer on prior mammography, US, or MRI. Axillary evaluation after completion of neoadjuvant chemotherapy, axilla previously evaluated. Next imaging study. Digital Breast Tomosynthesis Diagnostic Although many patients undergo mammography or DBT after NAC, there is no specific evidence supporting its use in the imaging of known axillary lymph node-positive breast cancer after completion of therapy.