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Background  Patients with hormone receptor-positive breast cancer typically show favorable survival. However, identifying individuals at high risk of recurrence among these patients is a crucial issue. We tested the hypothesis that [ 18 F]-fluorodeoxyglucose positron emission tomography (FDG-PET) scans can help predict prognosis in patients with hormone receptor-positive breast cancer.    Methods  Between April 2004 and December 2008, 305 patients with hormone receptor-positive breast cancer who underwent FGD-PET were enrolled. Patients with luminal B subtype were identified by positivity for human epidermal growth factor receptor-2 (HER2) or high Ki67 (≥14%) according to criteria recently recommended by the St. Gallen panelists. The cut-off value of SUV max  was defined using the time-dependent receiver operator characteristic curve for recurrence-free survival (RFS).    Results  At a median follow up of 6.23 years, continuous SUV max  was a significant prognostic factor with a hazard ratio (HR) of 1.21 ( p  = 0.021). The cut-off value of SUV max  was defined as 4. Patients with luminal B subtype ( n  = 82) or high SUV max  ( n  = 107) showed a reduced RFS ( p  = 0.031 and 0.002, respectively). In multivariate analysis for RFS, SUV max  carried independent prognostic significance ( p  = 0.012) whereas classification with immunohistochemical markers did not ( p  = 0.274). The Harell  c -index was 0.729. High SUV max  was significantly associated with larger tumor size, positive nodes, HER2 positivity, high Ki67 (≥14%), high tumor grade, and luminal B subtype.    Conclusions  Among patients with hormone receptor-positive breast cancer, FDG-PET can help discriminate patients at high risk of tumor relapse.

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[18F]-Fluorodeoxyglucose Positron Emission Tomography Can Contribute to Discriminate Patients with Poor Prognosis in Hormone Receptor-Positive Breast Cancer