False-Positive 68Ga-Fibroblast Activation Protein-Specific Inhibitor Uptake of Benign Lymphoid Tissue in a Patient With Breast Cancer

Ga-68-fibroblast activation protein-specific inhibitor (FAPI)-04 PET/CT was performed in a patient with left lower outer quadrant breast cancer who had F-18-FDG PET/CT imaging. Ga-68-FAPI-04 PET/CT showed higher accumulation of radiotracer in primary tumor and axillary lymph nodes than F-18-FDG PET/CT. In addition, focal increased FAPI uptake was observed in another nodular lesion in the lower inner quadrant in the same breast, which was considered malignant. However, Tru-Cut biopsy of this lesion was reported as benign lymphoid tissue. This case showed that all FAPI accumulation in breast tissue should not be interpreted in favor of malignancy; histopathological confirmation is required.