Evaluation of thoracic manifestations of breast cancer

Abstract

SUMMARY Objectives: Clinical and radiological features of 36 patients with breast cancer were investigated retrospectively. Materials and methods: Patients with breast cancer who had pulmonary complaints and radiologic abnormalities observed during oncology follow-ups were hospitalized, and investigated in clinics of chest disease. Pulmonary lesions were classified into 2 groups; Group I: malignant lesions due to metastasis of breast cancer, and Group II: nonmalignant lesions. Results: The mean age of the patients was 52.4±14.8 (28-93) years. Thirty-four patients were previously diagnosed with unilateral and 2 patients with bilateral ductal breast carcinoma. Twenty seven percent (n=10) of the patients were smokers (mean 10.7±6.81 pack-years). The mean time between the detection of breast cancer and the manifestations of pulmonary symptoms was 57.02±53.83 (3-180) months). The most common radiological abnormality was pleural effusion (n=23;63.9 %). Twenty-seven (75 %) patients had malignant (Group I), and 9 (25 %) patients had nonmalignant (Group II) pulmonary lesions. Malignant histopathology (n=27) was established by pleural fluid cytology in 13 (48.1 %), fiber optic bronchoscopy in 8 (29.6 %), pleural biopsy in 4 (14.8 %), CT guided transthoracic needle aspiration biopsy in 1 (3.7 %) and thoracotomy in 1 (3.7 %) patient, respectively. Mean time interval between the diagnosis of breast cancer and the detection of malignant pleural effusion was 69.91±64.21 (3-180) months. Nine (25 %) patients had nonmalignant pulmonary lesions including pneumonia in 3 (33.3 %), pulmonary thromboembolism and DVT in 3 (33,3 %), tuberculosis in 2 (22.2 %) and pulmonary fibrosis in 1 (11,1 %) patient. Conclusion: Pulmonary manifestations of breast cancer are most commonly related to metastases and can be observed in long time after the diagnosis of breast cancer. Besides, these nonmalignant reasons should be kept in mind and histopathologic confirmation should me made.