Objective  To understand the application value of ¹⁸F-FDG PET/CT in the diagnosis of recurrenceand metastasis of breast cancer patients with increased serum CEA and/or CA153 after treatment.

Methods ¹⁸F-FDG PET/CT images of 56 breast cancer patients who underwent surgery with or without chemotherapyor radiotherapy were acquired in three days to one month after increased serum CEA and(or) CA153 werefound. Diagnoses were made by the consistent comment of two or more doctors after three experiencednuclear medicine doctors reviewed the images retrospectively and independently. And the gold standard ofdiagnoses were the results of either pathology or one-year follow-up.

Results  Of all 56 cases, there were twocases of local recurrence, 30 cases of metastasis, 14 cases without recurrence and 10 cases of second primarytumor. ¹⁸F-FDG PET/CT imaging was positive in 41 cases (one false positive case), negative in 15 cases (twofalse negative cases). The diagnostic efficiency of ¹⁸F-FDG PET/CT were: sensitivity 95.24%, specificity92.86%, accuracy 94.64%, false negative rate 4.76%, false positive rate 7.14%, positive predictive value(PPV) 97.56%, and negative predictive value (NPV) 86.67%. The PPV of increased CEA alone, increasedCA153 alone and their combination were 57.14%, 90.91% and 94.12%, respectively (χ²=10.430, P=0.005).

Conclusion  ¹⁸F-FDG PET/CT can be used to identify or rule out the recurrence and metastasis in breastcancer patients with increased serum CA153 and(or) CEA after treatment, with high diagnostic efficiency andgood clinical application value. And it can also suggest the second primary tumor.