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Pulmonary resection and systemic lymph node dissection in a patient with breast cancer who had a 33-year disease-free interval.

Yin D, Zhang G, Zhao L, Chai Y - World J Surg Oncol (2015)

Bottom Line: An involved lobectomy and systematic mediastinal lymph node dissection were performed.The histological examination confirmed pulmonary metastasis from the breast cancer associated with mediastinal lymph nodes metastasis.Systematic mediastinal lymph node dissection should be considered as a prognostic study during pulmonary metastasectomy for breast cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, # 88 Jiefang Road, Hangzhou, 310009, China. ydg409@163.com.

ABSTRACT

Objective: Breast cancer metastasis to the lung is common. The resection of lung metastases in patients with breast cancer has been controversial. Here, we present a very rare case of pulmonary and mediastinal lymph node metastases in a patient with breast cancer who had a disease-free interval (DFI) of more than 33 years.

Methods: An involved lobectomy and systematic mediastinal lymph node dissection were performed.

Results: The histological examination confirmed pulmonary metastasis from the breast cancer associated with mediastinal lymph nodes metastasis.

Conclusions: To our knowledge, this is the first case reported of a patient with a 33-year DFI after a radical mastectomy for breast cancer who presented with pulmonary metastasis with mediastinal lymph node involvement. This case indicates that a long-term follow-up of breast cancer patients is necessary. Systematic mediastinal lymph node dissection should be considered as a prognostic study during pulmonary metastasectomy for breast cancer.

No MeSH data available.


Related in: MedlinePlus

Lung postoperative pathology (H & E staining, ×200): metastatic breast ductal carcinoma.
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Fig2: Lung postoperative pathology (H & E staining, ×200): metastatic breast ductal carcinoma.

Mentions: However, the final pathology confirmed breast ductal cancer metastasis (Figure 2). The largest diameter of the tumor was 2 cm, and the left lower paratracheal and subaortic lymph nodes were positive (Figure 3). The immunohistochemical results were as follows: estrogen receptor + + +, progesterone receptor +, human epidermal growth factor receptor 2 (HER2) + +, and Ki67 (20 to 30%). Overexpression and amplification of HER2 were detected by FISH. Moreover, the pathological examination showed similar results to those observed in the specimen 33 years earlier (Figure 4). As a result, a metastatic ductal carcinoma from the breast was diagnosed. Additionally, the left lower paratracheal and subaortic lymph nodes were positive (Figure 3), but the other lymph nodes were negative.Figure 2


Pulmonary resection and systemic lymph node dissection in a patient with breast cancer who had a 33-year disease-free interval.

Yin D, Zhang G, Zhao L, Chai Y - World J Surg Oncol (2015)

Lung postoperative pathology (H & E staining, ×200): metastatic breast ductal carcinoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4403715&req=5

Fig2: Lung postoperative pathology (H & E staining, ×200): metastatic breast ductal carcinoma.
Mentions: However, the final pathology confirmed breast ductal cancer metastasis (Figure 2). The largest diameter of the tumor was 2 cm, and the left lower paratracheal and subaortic lymph nodes were positive (Figure 3). The immunohistochemical results were as follows: estrogen receptor + + +, progesterone receptor +, human epidermal growth factor receptor 2 (HER2) + +, and Ki67 (20 to 30%). Overexpression and amplification of HER2 were detected by FISH. Moreover, the pathological examination showed similar results to those observed in the specimen 33 years earlier (Figure 4). As a result, a metastatic ductal carcinoma from the breast was diagnosed. Additionally, the left lower paratracheal and subaortic lymph nodes were positive (Figure 3), but the other lymph nodes were negative.Figure 2

Bottom Line: An involved lobectomy and systematic mediastinal lymph node dissection were performed.The histological examination confirmed pulmonary metastasis from the breast cancer associated with mediastinal lymph nodes metastasis.Systematic mediastinal lymph node dissection should be considered as a prognostic study during pulmonary metastasectomy for breast cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, # 88 Jiefang Road, Hangzhou, 310009, China. ydg409@163.com.

ABSTRACT

Objective: Breast cancer metastasis to the lung is common. The resection of lung metastases in patients with breast cancer has been controversial. Here, we present a very rare case of pulmonary and mediastinal lymph node metastases in a patient with breast cancer who had a disease-free interval (DFI) of more than 33 years.

Methods: An involved lobectomy and systematic mediastinal lymph node dissection were performed.

Results: The histological examination confirmed pulmonary metastasis from the breast cancer associated with mediastinal lymph nodes metastasis.

Conclusions: To our knowledge, this is the first case reported of a patient with a 33-year DFI after a radical mastectomy for breast cancer who presented with pulmonary metastasis with mediastinal lymph node involvement. This case indicates that a long-term follow-up of breast cancer patients is necessary. Systematic mediastinal lymph node dissection should be considered as a prognostic study during pulmonary metastasectomy for breast cancer.

No MeSH data available.


Related in: MedlinePlus