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Can PET scan replace needle biopsy?

Page last modified on: October 13, 2008
Question from Jax1: Can the PET scan replace the need of a needle biopsy?
Answers —Beth DuPree, M.D., F.A.C.S.: No.
Ruth Oratz, M.D., F.A.C.P.: PET [positron emission tomography] scan is a relatively new form of imaging, which looks at the metabolic activity of cells. Cancer cells, in general, are more active than normal cells in the body. PET scan uses a radioactively labeled form of glucose. Cancer cells pick up this glucose very avidly with great affinity, and on PET scan, malignant cells light up more brightly than normal cells. PET scans can be helpful in identifying areas of increased metabolic activity where there might be deposits of tumor cells, whether in a primary site, in the regional lymph nodes or in another area, such as a metastatic site. However, and this is a big however, PET scan is sensitive but not necessarily specific for cancer cells. Other conditions may cause increased metabolic uptake of glucose; for example, infections or inflammation. Furthermore, the amount of uptake may vary, depending on the nature of the metabolic process. I think a PET scan as a very rough road map. The PET scan points out areas of concern, but it is not definitively diagnostic of malignancy. Other imaging modalities and ultimately pathologic correlation with a biopsy may be required to define whether or not cancer is present in a particular site.
Beth DuPree, M.D., F.A.C.S.: PEM (positron emission mammography) is an imaging study currently under investigation that has potential in defining extent of disease in the breast when determining potential treatment modalities in breast cancer. But as Dr. Oratz has pointed out, the scan can show many things that take up glucose that are not necessarily cancer. Therefore, it is one of many diagnostic studies that could be used in the workup of a breast lesion.

On Wednesday, September 20, 2006, our Ask-the-Expert Online Conference was called Open for Your Questions. Ruth Oratz, M.D., F.A.C.P. and moderator Beth Baughman DuPree, M.D., F.A.C.S. answered your questions covering a wide variety of issues relating to breast cancer.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Ruth Oratz, M.D., F.A.C.P.Ruth Oratz, M.D., F.A.C.P. is associate professor of clinical medicine at New York University School of Medicine. She is the founder of The Women's Oncology & Wellness Practice in New York City where she specializes in treating women with breast cancer and other malignancies, as well as women at risk for cancer. 

Beth Baughman DuPree, M.D., F.A.C.S.Beth Baughman DuPree, M.D., F.A.C.S. is a general surgeon. Her clinical practice is located at Holy Redeemer Hospital and St. Mary Medical Center.

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