Pulmonary resection for metastatic breast cancer

McDonald, Monica; Deschamps, Claude; Ilstrup, Duane M.; Allen, Mark S.; Trantek, Victor F.; Pairolero, Peter C.

doi:10.1016/0003-4975(94)91639-x

Cited by 114 publications

(69 citation statements)

References 12 publications

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“…Lung metastasis commonly occurs within 5 years of the diagnosis of breast cancer, but the interval can vary considerably, and the metastasis can even appear more than 20 years after the initial diagnosis of breast cancer. 22,23 An endobronchial metastasis is another presentation that can simulate primary lung cancer. Although endobronchial metastasis is not a common pattern of metastasis, breast cancer is one of the most common causes of endobronchial metastasis.…”

Section: Discussionmentioning

confidence: 99%

A study of immunohistochemical differential expression in pulmonary and mammary carcinomas

2010

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The risk of developing a second primary cancer is increased in patients with breast cancer, and the lung is one of the major sites involved. Moreover, the lung is the major metastatic site for breast cancers. A distinction between metastatic breast cancer and primary lung cancer can be histologically difficult, and both show an overlapping CK7 þ /CK20À immunoprofile in a majority of cases. The degree of difficulty increases with poorly differentiated tumors. We investigated differential expressions of TTF-1, Napsin A, surfactant apoprotein A, estrogen receptor, GATA-3, mammaglobin, and GCDFP-15 immunostains in 197 pulmonary carcinomas (158 adenocarcinomas, 39 squamous) and 115 invasive mammary carcinomas (91 ductal, 24 lobular type). In mammary carcinomas, estrogen receptor, GATA-3, mammaglobin, and GCDFP-15 were expressed in 74, 72, 64, and 62%, respectively, whereas TTF-1, Napsin A, and surfactant apoprotein A were all negative. The expressions were diffuse in estrogen receptor and GATA-3, and variable in mammaglobin and GCDFP-15. For a combination of estrogen receptor/mammaglobin or GATA-3/mammaglobin, 83% of mammary carcinomas were positive, and the detection rate was not improved by using all three markers. All lung squamous cell carcinomas were negative for all markers studied. TTF-1, Napsin A, and surfactant apoprotein A were positive in 80, 77, and 45% of pulmonary adenocarcinomas. None of the TTF-1-negative tumors expressed surfactant apoprotein A. GCDFP-15 was focally expressed in 2.5% of pulmonary adenocarcinomas, and estrogen receptor was focally expressed in one case (1.2%) of pulmonary adenocarcinoma. When metastasis from breast cancer is suspected in the lung, a combination of either estrogen receptor/mammaglobin or GATA-3/mammaglobin as breast markers, and a combination of TTF-1 and Napsin A as lung markers may be helpful for differentiating between the two. Caution should be taken in the interpretation of GCDFP-15 due to its occasional expression in pulmonary adenocarcinomas.

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Section: Discussionmentioning

confidence: 99%

A study of immunohistochemical differential expression in pulmonary and mammary carcinomas

2010

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“…Metastatic disease of breast cancer responds very well to systemic chemotherapy and/or antihormonal therapy, resulting in an unclear role for surgical resection. Some studies report no benefit in overall survival for patients undergoing complete metastasectomy for breast cancer compared to systemic chemotherapy or to patients undergoing an incomplete resection, whereas others do find a survival benefit (47)(48)(49)(50)(51). However, in selected cases, with a DFI of more than 36 months and complete resection, a long disease-free and overall survival period may be obtained (52,53).…”

Section: Lung Metastasectomy For Different Histological Tumours 1 Brmentioning

confidence: 95%

Lung Metastatic Disease: Surgical Resection and Locoregional Chemotherapy

Hengst¹,

Hendriks²,

Schil³

2012

Toraks Cer Bult

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Currently, surgical resection remains the gold standard for resectable lung metastases. Prognostic factors are histology, complete resection, number of metastases and disease-free interval. However, there is a high rate of recurrent disease in the thorax, even if systemic chemotherapy is applied. Because the latter is limited in dose due to systemic toxicity, new treatment options are being developed to selectively deliver high-dose chemotherapy into the lung, reducing systemic toxicity. Isolated lung perfusion (ILuP), similar to isolated limb perfusion, is an experimental surgical technique to deliver highdose chemotherapy into the lung without systemic exposure. Biological response modifiers like tumour necrosis factor can also be administered. ILuP results in significantly higher concentration of chemotherapy in the target organ compared to systemic chemotherapy, together with a survival benefit in experimental models of pulmonary metastases. Several phase I studies have shown that ILuP is technically feasible with low morbidity and low impact on the patient's pulmonary function. However, the utility of this technique is limited because it is an invasive technique. Other techniques to selectively deliver high-dose locoregional chemotherapy are embolic trapping (chemo-embolization), selective pulmonary artery perfusion (SPAP) without control of the venous effluent and the minimally invasive lung suffusion technique. This review will discuss surgical resection of lung metastases and address several techniques developed to deliver high doses of chemotherapy into the lung, as well as the current progress in experimental and clinical studies.

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“…[17,18] Pulmonary metastasectomy for metastatic breast cancer was begun more than two decades ago and, since then, few studies were performed which reported significant effects of metastasectomy in improving overall and long-term survival. [16,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] In a recent metaanalysis, the pooled overall five-year survival rate following pulmonary metastasectomy was found to be 46% in patients with breast cancer, while it was 22.5% following systemic treatment in patients with metastatic breast cancer. [34,35] In another study, Yhim et al [30] compared the results of pulmonary metastasectomy in 15 patients with metastatic breast cancer with 30 patients who received systemic treatment alone, and found significantly longer progression-free survival and overall survival in the metastasectomy group.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes and prognostic factors of pulmonary metastasectomy in breast cancer patients: a systematic review

Sourati¹

2017

Turk Gogus Kalp Dama

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ÖZMeme kanseri, gelişmekte olan ülkelerde kadınlarda kansere bağlı ölümlerin başlıca nedenidir. Bu sistematik derlemede, meme kanserli hastalarda akciğer metastazektomisinin uzun dönem sonuçları ve prognostik faktörleri değerlendirildi. MEDLINE, Web of Science ve Scopus veri tabanlarında belirli anahtar sözcükler kullanılarak kapsamlı bir tarama yapıldı. Bu derlemeye Nisan 1990 -Nisan 2016 tarihleri arasında meme kanserli hastalarda pulmoner metastazektominin sonuçları ve prognostik faktörlerine ilişkin çalışmaların tümü dahil edildi. Çalışmaların 10'unda hastalıksız geçen süre, üçünde metastaz bölgesi, beşinde metastaz sayısı ve rezeksiyon genişliği ve altısında hormon reseptör statüsünün prognostik faktör olduğu belirlendi. Çalışma sonuçlarımıza göre, sırasıyla hastalıksız geçen süre, hormon reseptör statüsü, metastaz sayısı, metastatik rezeksiyon genişliği ve metastaz bölgesi meme kanserli hastalarda pulmoner metastazektominin önemli prognostik faktörleridir.Anah tar söz cük ler: Meme kanseri; akciğer metastazı; metastaz; pulmoner metastazektomi. ABSTRACTBreast cancer is the leading cause of cancer-related deaths in women in developing countries. The aim of this systematic review was to evaluate long-term outcomes and prognostic factors of pulmonary metastasectomy in patients with breast cancer. A comprehensive search was performed in the MEDLINE, Web of Science, and Scopus databases using selected keywords. All studies regarding the outcomes and prognostic factors of pulmonary metastasectomy in patients with breast cancer between April 1990 and April 2016 were included in this review. Disease-free interval was identified as a prognostic factor in 10, size of metastasis in three, number of metastases and width of resection in five, and hormone receptor status in six studies. According to our study results, disease-free interval, hormone receptor status, number of metastases, width of metastatic resection and size of metastases, in a descending order, are important prognostic factors for pulmonary metastasectomy in patients with breast cancer.

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Pulmonary resection for metastatic breast cancer

Cited by 114 publications

References 12 publications

A study of immunohistochemical differential expression in pulmonary and mammary carcinomas

A study of immunohistochemical differential expression in pulmonary and mammary carcinomas

Lung Metastatic Disease: Surgical Resection and Locoregional Chemotherapy

Long-term outcomes and prognostic factors of pulmonary metastasectomy in breast cancer patients: a systematic review

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