Objective To evaluate the clinical value of ¹⁸F-FDG PET/CT imaging in detecting the recurrence and metastasis, therapeutic strategy, and prognosis of postoperative breast cancer patients.

Methods From July 2007 to September 2016, 59 patients with postoperative breast cancer were retrospectively studied. The influence of PET/CT imaging results on the choice of therapeutic strategy was analyzed. Kaplan-Meier survival analysis was conducted based on the true-positive and true-negative groups of patients. Comparison of SUV_max according to the age, estrogen receptor(ER), progesterone receptor (PR), human epidermal growth factor receptor-2(HER2), and subtypes of the patients in the PET/CT imaging true-positive group was performed using t-test.

Results The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of ¹⁸F-FDG PET/CT were 100%, 87.5%, 94.9%, 92.1%, and 100%, respectively. No statistically significant difference in the SUV_max for breast cancer recurrence and metastasis was observed between the two groups of patients according to age, ER, PR, HER2, and subtypes of breast cancer(t=0.808, 0.225, 0.355, -0.426 and -1.076, all P>0.05). The true-positive and true-negative groups were followed for a median period of 58.33±37.69 and 47.40±25.99 months, and their median survival times were 3.58 and 4.16 years, respectively. The two groups significantly differed in the overall survival and progression-free survival times (Kaplan-Meier survival analysis, χ²=10.274, P < 0.01; χ²=17.187, P < 0.01). Clinical restaging was raised in 25 true-positive patients after PET/CT imaging, and the therapeutic strategy was changed in 30 true-positive patients.

Conclusions PET/CT imaging is highly sensitive and accurate in diagnosing the recurrence and metastasis of postoperative breast cancer and allows clinical restaging in a timely manner. It helps in choosing the appropriate clinical therapeutic strategy, thereby improving the prognosis of patients. Compared with the true-positive patients, the true-negative patients who underwent PET/CT imaging had a better prognosis. Therefore, PET/CT imaging has a high clinical value in the follow-up of postoperative breast cancer patients.