Arlington Heights, Ill.– The National Comprehensive Cancer Network (NCCN) has updated its Clinical Practice Guidelines in Oncology to recommend the use of fluoroestradiol (FES) PET imaging for patients with recurrent or metastatic invasive lobular carcinoma (ILC), a common yet often difficult-to-detect form of breast cancer. The new recommendation could significantly improve diagnostic accuracy and access to care for thousands of patients, while also supporting earlier interventions and more informed treatment decisions.
The updated guidelines specifically suggest that clinicians consider whole-body FES PET imaging when systemic staging is needed in patients with suspected estrogen receptor-positive (ER+) lobular breast cancer. GE HealthCare’s Cerianna™ (fluoroestradiol F18) is currently the only FDA-approved imaging agent for identifying ER+ breast cancer lesions, including those from ILC, which often evade detection through traditional imaging methods.
Lobular breast cancer accounts for approximately 10 to 15 percent of all breast cancer cases in the U.S., with an estimated 43,000 new diagnoses each year. Notably, about 95 percent of these tumors are estrogen receptor-positive. Unlike more common ductal tumors, lobular cancers rarely form detectable lumps and tend to spread in diffuse patterns, making diagnosis through mammography, ultrasound, or MRI more challenging. They can also metastasize to unusual sites like bones, brain, lungs, and gynecological organs and may recur more than a decade after initial diagnosis.
“With lobular cancers frequently missed during routine screening, they are often discovered at more advanced stages,” said Dr. Jit Saini, Chief Medical Officer of GE HealthCare’s Pharmaceutical Diagnostics division. “This update to the NCCN Guidelines gives oncologists added confidence to use Cerianna for detecting ER+ lesions in lobular breast cancer. It also paves the way for broader insurance coverage, enabling more patients to benefit from earlier and more precise diagnosis.”
Cerianna works by binding to functional estrogen receptors in tumors, allowing physicians to visualize receptor-positive lesions throughout the body using PET imaging. This approach offers a powerful complement to biopsy, particularly in cases where tumors are widespread or difficult to access.
The expanded guideline recommendation is the result of efforts by an expert working group organized by the Society of Nuclear Medicine and Molecular Imaging (SNMMI), in collaboration with breast care experts from organizations including the Lobular Breast Cancer Alliance and the American College of Nuclear Medicine. Their findings underscore the growing role of molecular imaging in detecting and managing complex cancers.
The NCCN, a not-for-profit alliance of 33 leading U.S. cancer centers, is widely recognized for setting the standard in oncology clinical guidelines. Its updates are closely followed by healthcare providers, payers, and policy makers.
GE HealthCare’s Pharmaceutical Diagnostics division supplies imaging agents used in roughly 130 million procedures globally each year. With its expanding molecular imaging portfolio, the company continues to drive innovation across oncology, neurology, and cardiology, aiming to enhance diagnosis, monitoring, and clinical outcomes.
