The clinical value of 18 F-fluoroestradiol in assisting individualized treatment decision in dual primary malignancies

Background For patients with previously diagnosed dual primary tumors, it is usually difficult to determine the diagnosis and treatment of stage IV recurrence. The study was to explore the influences of 18F-fluoroestradiol positron emission tomography/computed tomography (18F-FES PET/CT) in the diagnosis of estrogen receptor (ER) positive breast cancer combined with other primary tumor with distant metastases. Methods Multidisciplinary team were organized to explore the definite clinical value of 18F-FES PET/CT in stage IV patients suffered from ER-positive breast cancer and another primary tumor synchronously or metachronously. Thirty-two female patients were retrospectively analyzed who underwent 18F-FES PET/CT scans in our center. Before and after reading 18F-FES reports, the team members from department of surgery, oncology and radiotherapy should make decisions of management strategy. Results Totally, the multidisciplinary team completed the management decision-making of the 32 patients before and after 18F-FES PET/CT scans. 87.5% (n=28) of the patients were considered to benefit from 18F-FES reports for diagnosis and treatment decisions. Out of the 28 patients, 7 patients (7/32, 21.9%) were considered to definitely change the management strategies while 12 patients (12/32, 37.5%) was instructive to develop management plans after the scan. The other 9 patients were suggested reassuring decision-making process by 18F-FES PET/CT. Conclusions 18F-FES PET/CT scans have clinical effects on diagnosis and treatment strategies of stage IV patients suffered from ER-positive breast cancer and another primary tumor.