PET/CT in breast cancer.

Abstract

Breast cancer is one of the most prevalent neoplasms worldwide, with molecular subtypes that influence prognosis and therapeutic strategies. PET/CT with different radiopharmaceuticals has revolutionized diagnosis, staging, and treatment monitoring. [¹⁸F]-Fluorodeoxyglucose remains the most widely used radiotracer, but it has limitations in certain subtypes, such as invasive lobular carcinoma, where 16α-[¹⁸F] fluoro-17β-estradiol and [⁶⁸Ga]-FAPI (fibroblast activation protein inhibitors) have demonstrated greater utility. Today, HER2-targeted radiopharmaceuticals, such as [⁸⁹Zr]-trastuzumab, allow for a precise assessment of tumor heterogeneity. PET/CT also plays a key role in detecting bone metastases using [¹⁸F]-NaF and in identifying new therapeutic targets, such as PSMA (prostate-specific membrane antigen) and GRPR (gastrin-releasing peptide receptor). These advancements establish molecular imaging as an essential tool for personalizing breast cancer treatment, optimizing clinical decision-making, and improving diagnostic accuracy.