PET Imaging of Breast Cancer: Beyond Standard FDG Studies

As breast cancer treatment moves toward more individualized, targeted therapy, the ability to characterize the in vivo tumor phenotype will play a key role in the selection of therapy and evaluation of its efficacy. PET imaging is well suited to guide targeted breast cancer therapy by evaluating the presence or absence of specific targets, identifying resistant phenotypes, and measuring early response to treatment. More sophisticated analysis of FDG PET studies, and especially PET using tracers other than FDG, have yielded insights into the in vivo biology of breast cancer in early studies and are likely to contribute to breast cancer care in the future. This review will highlight the biology of breast cancer using recent data of more detailed analysis of FDG PET studies to gain insight into resistant tumors, followed by PET imaging of the breast cancer with other tracers beyond FDG.