The impact of PET-FES on changing therapeutic conduct in bilateral luminal phenotype breast cancer
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https://doi.org/10.29289/2594539420250055Palavras-chave:
breast neoplasms, positron emission tomography, neoplasm staging, access to health services, health equityResumo
Positron emission tomography with ¹⁸F-fluoroestradiol (PET-FES) is a functional imaging exam that assesses the expression of estrogen receptors and is highly sensitive in detecting metastases in luminal tumors, which represent the majority of breast cancer cases. We report the case of a 75-year-old patient with bilateral breast carcinoma, whose initial treatment would be adjuvant chemotherapy based on positron emission tomography/computed tomography (PET-CT) with fluorodeoxyglucose (FDG), which showed no evidence of metastases. However, PET-FES identified metastatic involvement in lymph nodes and the skeleton, reclassifying the disease to stage IV. This new assessment made it possible to replace chemotherapy with endocrine therapy associated with cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors, a more effective and less toxic approach for the metastatic scenario. The unavailability of PET-FES in the public system and in several private health insurance plans constitutes an ethical imperative, as it limits access to precision diagnostics. This reality highlights structural inequalities in Brazilian oncology, representing a dilemma that requires public policies and evidence-based solutions to ensure equity in cancer treatment.
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Copyright (c) 2026 Maria Marta Martins, Adrienne Pratti Lucarelli, Gabriela Martins Vasconcelos, Paulo Henrique do Amor Divino, Giulia Dematte Szechtman, Maria Silveira Rea
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
