P Assouline1, M-B Léger-Ravet2, R Saffroy3, J Hamelin3, A Bénissad4, P Husleag5, A Lemoine3, G Oliviéro5. 1. Service de pneumologie et d'oncologie thoracique, groupe hospitalier Nord Essonne, 159, rue du Président-François-Mitterrand, 91160 Longjumeau cedex 01, France. Electronic address: p.assouline@gh-nord-essonne.fr. 2. Service d'anatomie et de cytologie pathologiques, groupe hospitalier Nord Essonne, 91160 Longjumeau cedex 01, France. 3. Service de biochimie et d'oncogénétique, hôpital Paul-Brousse, Assistance publique-Hôpitaux de Paris, 12, avenue Paul-Vaillant-Couturier, 94800 Villejuif, France. 4. Service d'imagerie médicale, groupe hospitalier Nord Essonne, 91160 Longjumeau cedex 01, France. 5. Service de pneumologie et d'oncologie thoracique, groupe hospitalier Nord Essonne, 159, rue du Président-François-Mitterrand, 91160 Longjumeau cedex 01, France.
Abstract
INTRODUCTION: The breast is a rare site for metastases from lung cancers. Their occurrence in patients with adenocarcinoma which has the EGFR mutation is exceptional. In this context, it is sometimes difficult to differentiate a second primary breast cancer from a breast metastasis. OBSERVATIONS: We report the cases of two patients who developed breast metastases from lung adenocarcinoma that was TTF1 positive with a deletion of exon 19 of the EGFR gene. A non-smoking woman of Asian origin, presented with a solitary breast metastasis 29 months after being established on first-line chemotherapy. The second case was a Caucasian patient who was an active smoker presented with tumor progression with multiple metastases including involvement of both breasts 10 months after the start of treatment with a tyrosine kinase inhibitor. In both, tumor cells from the breast showed positive immunostaining for TTF1 and genotyping detected the presence of the deletion of exon 19 of the EGFR gene. CONCLUSION: In patients with lung adenocarcinoma and EGFR mutation, immunohistochemical examination, including TTF1 and genotyping of synchronous breast tumour, is needed to confirm its metastatic nature and to guide treatment.
INTRODUCTION: The breast is a rare site for metastases from lung cancers. Their occurrence in patients with adenocarcinoma which has the EGFR mutation is exceptional. In this context, it is sometimes difficult to differentiate a second primary breast cancer from a breast metastasis. OBSERVATIONS: We report the cases of two patients who developed breast metastases from lung adenocarcinoma that was TTF1 positive with a deletion of exon 19 of the EGFR gene. A non-smoking woman of Asian origin, presented with a solitary breast metastasis 29 months after being established on first-line chemotherapy. The second case was a Caucasian patient who was an active smoker presented with tumor progression with multiple metastases including involvement of both breasts 10 months after the start of treatment with a tyrosine kinase inhibitor. In both, tumor cells from the breast showed positive immunostaining for TTF1 and genotyping detected the presence of the deletion of exon 19 of the EGFR gene. CONCLUSION: In patients with lung adenocarcinoma and EGFR mutation, immunohistochemical examination, including TTF1 and genotyping of synchronous breast tumour, is needed to confirm its metastatic nature and to guide treatment.