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Open Access Highly Accessed Research article

A pilot study of FDG PET/CT detects a link between brown adipose tissue and breast cancer

Qi Cao1, Jerome Hersl2, Hongloan La3, Mark Smith1, Jason Jenkins1, Olga Goloubeva4, Vasken Dilsizian1, Katherine Tkaczuk3, Wengen Chen1* and Laundette Jones2*

Author Affiliations

1 Departments of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 21201 Baltimore, MD, USA

2 Department of Pharmacology, University of Maryland School of Medicine, 21201 Baltimore, MD, USA

3 The University of Maryland Marlene and Stewart Greenebaum Cancer Center, 21201 Baltimore, MD, USA

4 Department of Epidemiology and Public Health, University of Maryland School of Medicine, 21201 Baltimore, MD, USA

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BMC Cancer 2014, 14:126  doi:10.1186/1471-2407-14-126

Published: 25 February 2014

Abstract

Background

Breast cancer is the second most lethal cancer in women. Understanding biological mechanisms that cause progression of this disease could yield new targets for prevention and treatment. Recent experimental studies suggest that brown adipose tissue (BAT) may play a key role in breast cancer progression. The primary objective for this pilot study was to determine if the prevalence of active BAT in patients with breast cancer is increased compared to cancer patients with other malignancies.

Methods

We retrospectively analyzed data from 96 breast cancer patients who had FDG PET/CT scan for routine staging at the University of Maryland and 96 age- and weight-matched control female patients with other malignancies (predominantly colon cancer) who had undergone FDG PET/CT imaging on the same day. Data on the distribution (bilateral upper neck, supraclavicular and paraspinal regions) and intensity (SUVmax) of active BAT were evaluated by 2 Nuclear Medicine physicians, blinded to the clinical history.

Results

We found sufficient evidence to conclude that based on our sample data the prevalence of active BAT in breast cancer patients’ group is significantly different from that in the control group. The estimated frequency of BAT activity was 3 fold higher in breast cancer patients as compared to controls with other cancers, (16.7% vs. 5.2%, respectively, p = 0.019). When patients were stratified by age in order to determine the possible impact of age related hormonal changes on active BAT among the younger women (≤ 55 years of age), 25.6% breast cancer patients exhibited BAT activity compared to only 2.8% in control women (p = 0.007). In contrast, among the older women (> 55 years of age), the prevalence of active BAT was similar among breast cancer and control women (10.7% vs 6.7%).

Conclusions

In breast cancer patients prevalence of BAT activity on FDGPET/CT is 3-fold greater than in age- and body weight-matched patients with other solid tumor malignancies; this difference is particularly striking among younger women aged < =55. In summary, our retrospective clinical data provide support to pursue prospective clinical and translational studies to further define the role of BAT in breast cancer development and progression.

Keywords:
Breast cancer; Brown adipose tissue; FDG PET/CT