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Breast Cancer Treatment Studies / Medical Imaging Techniques and Applications / Cancer, Hypoxia, and Metabolism · Journal article
Diagnostics · September 9, 2026
Encouraging direction, but not yet definitive.
This retrospective study of 162 stage II–III breast cancer patients demonstrates that PET/CT-derived metabolic parameters (change in primary tumor SUVmax and post-treatment SUVmax) are independently associated with pathological complete response and improve discriminatory accuracy beyond clinical factors alone (AUC increase of 0.101–0.132, p ≤ 0.001). However, the association was inconsistent across molecular subtypes, reaching statistical significance only in HER2-positive disease, limiting generalizability and requiring prospective validation.
Retrospective cohort study. 162 patients with stage II–III breast cancer who received neoadjuvant systemic therapy followed by surgery.. Intervention: 18F-FDG PET/CT-derived metabolic parameters (baseline SUVmax, post-treatment SUVmax, ΔSUVmax of primary tumor and axillary lymph nodes) in predictive models for pathological complete response.. Compared with: Clinicopathological factors alone (clinical-only models) as baseline comparator for model discrimination.. n = 162.
Sixty-three of 162 patients (38.9%) achieved pathological complete response. Higher percentage change in primary tumor SUVmax and lower post-treatment primary tumor SUVmax were independently associated with pCR in separate multivariable models. Model AUCs were 0.837 (ΔPrimary Tumor SUVmax) and 0.848 (post-treatment primary tumor SUVmax).
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If validated prospectively, PET/CT metabolic parameters could improve prediction of treatment response and inform surgical planning in breast cancer. The inconsistent performance across molecular subtypes suggests that prediction models may need subtype-specific calibration, particularly for HER2-positive disease.
Retrospective single-center study of moderate size showing PET/CT parameters independently predict pathological complete response with improved model discrimination, but lacks prospective validation and external generalization.
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Quoted from the source exactly as published.
If validated prospectively, PET/CT metabolic parameters could improve prediction of treatment response and inform surgical planning in breast cancer. The inconsistent performance across molecular subtypes suggests that prediction models may need subtype-specific calibration, particularly for HER2-positive disease.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background: Pathological complete response (pCR) following neoadjuvant systemic therapy (NST) is associated with improved outcomes in breast cancer. We evaluated the association between PET/CT-derived metabolic parameters and pCR and explored whether these associations differed according to molecular subtype. Methods: This retrospective study included 162 patients with stage II–III breast cancer who received NST followed by surgery and underwent 18F-FDG PET/CT at baseline and after completion of NST before surgery. Baseline SUVmax, post-treatment SUVmax, and percentage change in SUVmax (ΔSUVmax) were assessed for the primary tumor and axillary lymph nodes. Multivariable logistic regression and model performance analyses were performed. Results: Sixty-three patients (38.9%) achieved pCR. Higher ΔPrimary Tumor SUVmax and lower post-treatment primary tumor SUVmax were independently associated with pCR in separate multivariable models. The corresponding model AUCs were 0.837 and 0.848. Addition of PET-derived parameters to clinical-only models increased the AUC by 0.101 and 0.132, respectively (DeLong p = 0.001 and p < 0.001). No significant interaction was observed between ΔPrimary Tumor SUVmax and molecular subtype; in exploratory subgroup analyses, the association reached statistical significance in the HER2-positive subgroup only. Conclusions: PET/CT-derived metabolic parameters were independently associated with pCR and provided additional discriminatory information beyond clinicopathological factors. No significant interaction with molecular subtype was observed.
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