Locoregional nodal status at initial presentation on ultrasound (US) and positron emission tomography/computerized tomography (F-FDG PET/CT) in inflammatory breast cancer (IBC) patients is predictive of overall survival

Authors

Andrea Tenreiro, Breast Imaging Section, Department of Diagnostic Radiology, University of Texas Medical Branch, Galveston, TX.
Jia Sun, Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX.
Gary Whitman, Department of Breast Imaging, Division of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX.
Annie Dinh, Advocate Health - MidwestFollow
Megumi Kai, Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer Center Morgan Welch Inflammatory Breast Cancer Clinic and Research Program, University of Texas MD Anderson Cancer Center, Houston, TX.
Yang Lu, Department of Nuclear Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
Sadia Saleem, Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX.
Mary Guirguis, Department of Breast Imaging, Division of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX.
Miral Patel, Department of Breast Imaging, Division of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX.
Anthony Lucci, The University of Texas MD Anderson Cancer Center Morgan Welch Inflammatory Breast Cancer Clinic and Research Program, University of Texas MD Anderson Cancer Center, Houston, TX; Department of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX.

Recommended Citation

Tenreiro A, Sun J, Whitman G, et al. Locoregional Nodal Status at Initial Presentation on Ultrasound (US) and Positron Emission Tomography/Computerized Tomography (18F-FDG PET/CT) in Inflammatory Breast Cancer (IBC) Patients is Predictive of Overall Survival. Clin Breast Cancer. Published online February 12, 2026. doi:10.1016/j.clbc.2026.01.013

Affiliations

Advocate Health Christ Medical Center

Abstract

Background: Inflammatory Breast Cancer (IBC) is an aggressive breast cancer with poor prognosis. Nodal staging with ultrasound (US) and ¹⁸F-FDG PET/CT (FDG PET/CT) is accurate and beneficial for determining locoregional treatment. The aim of this study is to determine if the nodal disease distribution at initial presentation on US and FDG PET/CT can predict overall survival (OS).

Methods: Nodal features of patients with IBC from an Institutional Review Board approved registry, who received both US and FDG PET/CT, were retrospectively analyzed. Kaplan-Meier method and Cox regression were used to evaluate the association of nodal distribution predictors with overall survival, and the exact McNemar test to compare nodal distribution between US and FDG PET/CT.

Results: Of 188 IBC patients, US detected malignant ipsilateral adenopathy in 55.9%, 33.5%, and 19.7% at axillary levels I, II, and III respectively, and FDG PET/CT in 51.6%, 29.3%, and 14.9%. FDG PET/CT detected supraclavicular lymphadenopathy (SC) in 20.7%. No statistically significant difference was found between US and FDG PET/CT for detection of ipsilateral nodal disease. Median OS was 3.99 years (95% CI, 3.38-6.35 years). Worse prognosis was associated with contralateral SC (HR 4.05, P < .001) on FDG PET/CT, compared to ipsilateral SC (HR 1.93, P = .003) and ipsilateral axillary adenopathy (HR range, 1.16-1.87).

Conclusion: IBC patients with initial presentation of contralateral SC have significantly reduced OS by approximately 3 years. No statistically significant difference was noted between US or FDG PET/CT for ipsilateral locoregional staging in IBC. US performed by experienced operators showed detection rates comparable to FDG PET/CT. FDG PET/CT remains crucial for detecting distant metastases.

Document Type

Article

PubMed ID

41895005