Diagnosis and surgical resection of solitary pulmonary nodules in patients with breast cancer

Abstract

Abstract. The differential diagnosis of solitary pulmonary nodules (SPNs) using radiological features in patients with breast cancer is vital yet difficult. The nature of SPNs, of these patients, as well as the role of surgery in the diagnosis and treatment were evaluated. Thirty consecutive patients, who underwent surgery for an SPN between 2002 and 2011 subsequent to curative surgery for breast cancer were retrospectively evaluated. The overall survival and disease-free survival periods were estimated using the Kaplan-Meier method. The Student's t-test and the χ 2 test were performed to compare percentages and the mean values, respectively. The values were considered statistically significant at P<0.05. Most (93%) SPNs were malignant. The pathological diagnoses in patients with SPNs were primary lung cancer (n=20, 67%), pulmonary metastasis from breast (n=7, 23%) or colon (n=1, 3%) cancers and benign conditions (n=2, 7%). Of the 20 patients with primary lung cancer, 15 (75%) had stage IA tumors (T1aN0M0). The average disease-free interval was significantly longer in patients with primary lung cancer compared to patients with pulmonary metastases from breast cancer (P= 0.031). The five-year survival rates after pulmonary resection for lung metastasis from breast cancer patients and primary lung cancer patients were 100 and 61.1%, respectively. SPNs found in patients with breast cancer were found to have a high probability of malignancy, especially primary lung adenocarcinoma. The early resection of SPNs in patients diagnosed with both primary and metastatic lung cancer led to a good prognosis. The early pathological diagnosis by surgical resection was suggested to be conducted for the early diagnosis and appropriate treatment of SPNs in patients with breast cancer.

18Fluorodeoxyglucose‐positron emission tomography/computed tomography features of suspected solitary pulmonary lesions in breast cancer patients following previous curative treatment

“…According to our data, approximately 15% of all patients were false positive cases. Similar results have been reported in other studies . Thus, we should note that the proportion of benign patients is not low, even in these patients.…”

“…Solitary pulmonary metastasis after curative treatment for breast cancer is rare in patients with breast malignancy. Although it is not difficult to detect lung lesions with advanced imaging technology, differentiating pulmonary metastasis from primary lung cancer and other benign conditions can be challenging after curative treatment for breast cancer …”

“…Recent studies have investigated the potential differences in clinical characteristics among breast cancer patients with SPLs however, the 18 F‐FDG‐PET/CT features in this population have not been well researched. In this retrospective study, we characterize the imaging features of 18 F‐FDG‐PET/CT to differentiate highly suspected SPLs resulting from breast cancer metastasis with primary lung cancer among breast cancer patients who received prior curative treatment, as well as those with benign pathology.…”

Differential expression of various clones of estrogen receptor in cell block preparation of lung adenocarcinoma

“…Conversely, solitary lung nodules are usually found as an incidental finding during the work‐up or follow‐up of breast cancer patients, and may represent a metastatic breast carcinoma to the lung or a new primary lung adenocarcinoma . ‐ In this setting, the new pulmonary lesions may pose a diagnostic challenge due to significant therapeutic implications . Lung nodules must therefore be carefully evaluated to distinguish between benign and malignant tumors, and primary versus metastatic malignancies.…”

“…[3][4][5] In this setting, the new pulmonary lesions may pose a diagnostic challenge due to significant therapeutic implications. 6,7 Lung nodules must therefore be carefully evaluated to distinguish between benign and malignant tumors, and primary versus metastatic malignancies. Initial evaluation of pulmonary nodules is commonly performed by less invasive procedures, such as endobronchial ultrasound guided fine needle aspiration (EBUS-FNA) of accessible nodules and cytologic evaluation of pleural effusions (PE).…”