Tumor marker-guided PET in breast cancer patients - A recipe for a perfect wedding: A systematic literature review and meta-analysis

Laura Evangelista, Anna Rita Cervino, Cristina Ghiotto, Adil Al-Nahhas, Domenico Rubello, Pier Carlo Muzzio

Research output: Contribution to journalArticlepeer-review


INTRODUCTION: Early detection of breast cancer (BC) recurrence is a fundamental issue during follow-up. Although the utilization of new therapeutic protocols aimed at reducing the recurrence risk is defined, the diagnostic approach for early detection remains to be clarified. We aim to provide a critical overview of recently published reports and perform a meta-analysis on the use of tumor markers in BC patients as a guide for fluorodeoxyglucose positron emission tomography (PET) imaging. METHODS: Medline and Google Scholar were used for searching English and non-English articles that evaluate the role of PET in BC recurrence when an increase in tumor markers is found. All complete studies were reviewed; thus, quantitative and qualitative analyses were performed. RESULTS: From 2001 to May 2011, we found 19 complete articles that critically evaluated the role of PET in BC recurrence detection in the presence of elevated tumor markers. The meta-analysis of the 13 studies provided the following results: pooled sensitivity 0.878 (95% CI: 0.838-0.909), pooled specificity 0.693 (95% CI: 0.553-0.805), and pooled accuracy 0.828 (95% CI: 0.762-0.878). CONCLUSIONS: The current experience confirms the potential of fluorodeoxyglucose PET, and in particular of PET/CT, in detecting occult soft tissue and bone metastases in the presence of a progressive increase of serum tumor markers in BC patients, but this should be better defined in the current practical recommendations.

Original languageEnglish
Pages (from-to)467-474
Number of pages8
JournalClinical Nuclear Medicine
Issue number5
Publication statusPublished - May 2012


  • breast cancer
  • cancer recurrence
  • PET
  • PET/CT
  • tumor markers

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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