A combined positron-emission tomography–magnetic resonance imaging (PET-MRI) scanning technique could improve the treatment of some patients with early-stage breast cancer, according to new findings presented by Di Micco et al at the 2024 European Breast Cancer Conference (EBCC) (Abstract 9) and simultaneously published in the European Journal of Cancer.
Background
“The standard approach for patients with early-[stage] breast cancer includes mammography, ultrasound, and sometimes MRI. Combined PET-MRI is a relatively new approach, so it’s generally only used in clinical research,” explained lead study author Rosa Di Micco, MRBS, PhD, a breast surgeon at the IRCCS San Raffaele University and Research Hospital in Milan, Italy.
Study Methods and Results
In the new study, researchers used PET-MRI scans to examine 205 patients with early-stage breast cancer treated between July 2020 and October 2023—with the goal of determining whether the cancer had spread in the affected breast, the surrounding area, or the rest of the body. The scans were performed prior to breast-conserving surgery.
The researchers found that 27.8% (n = 57) of the patients received altered treatments based on the results of the PET-MRI scans—18 of whom received chemotherapy as first-line therapy and 39 of whom received different surgical approaches such as mastectomy, removal of extra lymph nodes, and surgery on both breasts. Further, 21.1% (n = 12/57) of the patients had additional tumor tissue removed that was later determined to be benign.
Conclusions
The researchers emphasized that the new findings represented the potential to identify patients who could benefit from alternative treatments.
“Our research suggests that for patients with early-[stage] breast cancer, the addition of a PET-MRI scan to standard care could help us make more informed decisions about the best treatment pathway. However, results of this technique are still affected by a high percentage of false-positives and should therefore be confirmed by further testing,” Dr. Di Micco revealed.
“These are early results from an ongoing study, but they suggest that a PET-MRI scan could refine treatment for some [patients with] breast cancer. They also suggest that this is an area where more research could be beneficial,” proposed senior study author Oreste Gentilini, MD, Professor at the IRCCS San Raffaele University and Research Hospital in Milan, Italy.
The researchers are currently initiating a new study using a different PET-MRI approach that could help detect breast cancer cells growing in response to estrogen—particularly in patients with lobular breast cancer, which is often more difficult to detect on mammograms or ultrasounds.
“Once complete, this will be one of the largest studies of its kind looking at PET-MRI before surgery for patients with early-[stage] breast cancer. We look forward to more results from this study, but these findings suggest that PET-MRI could help spot early signs that breast cancer has begun to spread. Spotting these signs might give [patients] the best chance of long-term survival. We now need studies to prospectively test this hypothesis.” concluded Michail Ignatiadis, MD, PhD, of the Institut Jules Bordet in Brussels and Chair of the 2024 EBCC, who was not involved in the research.
Disclosure: The research in this study was funded in part by the Ricerca Finalizzata Ordinaria grant from the Italian Ministry of Health. For full disclosures of the study authors, visit ejcancer.com.
