A case of pulmonary metastasis from breast cancer following an 18-year disease-free interval that responded to tamoxifen treatment

Sole metastatic pulmonary nodules from breast cancer simulating primary lung adenocarcinoma: Two case reports

The characteristic radiological signs of primary lung adenocarcinoma include notching, lobulation, spicular formation, pleural indentation and a bronchus leading to the nodule (bronchus sign). However, metastatic tumors rarely display such characteristics. We herein present two cases of breast cancer with sole metastatic pulmonary tumors recurring ~20 years after surgery for breast cancer. These patients exhibited radiographic signs specific to primary lung adenocarcinoma. Pulmonary metastatic nodular lesions occur through hematogenous spread; therefore, obtaining pathological specimens by transbronchial biopsy may be challenging. In our patients, however, obtaining pathological specimens by transbronchial biopsy was feasible and it ultimately confirmed the diagnosis of lung metastasis from previously treated breast cancer. To the best of our knowledge, no similar cases are reported in the English medical literature. Therefore, metastatic breast cancer may exhibit the characteristic radiological signs of pulmonary lung adenocarcinoma and, although rare, pulmonary metastasis from breast cancer should be considered even in the presence of irregularly shaped pulmonary nodule(s) following long-term disease-free survival.

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

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.

Pulmonary metastasis from breast cancer with an 18-year disease-free interval: implication of the role of surgery

The appearance of pulmonary metastasis more than 15 years after primary treatment for breast cancer is rare. We herein report the case of a breast cancer patient with solitary pulmonary metastasis, after an 18-year disease-free period, treated with resection. A 66-year-old Japanese woman was found to exhibit an abnormal shadow on a chest X-ray. She had undergone a left mastectomy for breast cancer 18 years previously. The nodule was suspected to be either metastatic or primary lung cancer, and thus thoracoscopic surgery was performed. The histologic diagnosis was metastasis from breast cancer. Pulmonary resection in breast cancer recurrence is an important diagnostic tool that allows for a differential diagnosis with primary lung cancer. The clinical implication of surgery for a solitary pulmonary metastasis from breast cancer is discussed in this report.