Zuodong Song1,2, Ting Ye1,2, Longfei Ma1,2, Jiaqing Xiang3,4, Haiquan Chen5,6. 1. Department of Thoracic Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China. 2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. 3. Department of Thoracic Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China. j.q.xiang@hotmail.com. 4. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. j.q.xiang@hotmail.com. 5. Department of Thoracic Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China. hqchen1@yahoo.com. 6. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. hqchen1@yahoo.com.
Abstract
BACKGROUND: The role of surgery for isolated malignant pulmonary nodules in breast cancer patients remains unclear. METHODS: A total of 1286 consecutive breast cancer patients with pulmonary nodules detected by thoracic computed tomography (CT) or positron emission tomography (PET)/CT scan at Shanghai Cancer Center, Fudan University, were reviewed. Overall, 147 breast cancer patients with isolated malignant pulmonary nodules receiving surgery and/or chemotherapy were enrolled in the study. Patients were classified into three groups: patients with primary lung cancer (PLC) receiving surgery (Group 1), patients with lung metastasis receiving surgery (Group 2), and patients with lung metastasis receiving chemotherapy (Group 3). Survival outcomes, including overall survival (OS) and progression-free survival (PFS), were analyzed for patients in all three groups, and prognostic factors for PFS for patients with pulmonary metastasis were evaluated. RESULTS: Patients with PLC receiving surgery had better survival outcomes, including OS and PFS, than patients with lung metastases who received surgical resection. Breast cancer patients with solitary lung metastasis who received metastasectomy had a significantly better PFS than those who did not; however, no statistically significant difference in OS was observed between the two groups. A multivariate analysis conducted in patients with isolated metastatic breast cancer showed that surgery was an independent factor for better PFS. CONCLUSIONS: Surgery should be considered a valid option for the diagnosis and treatment of breast cancer patients presenting with isolated malignant lung nodules.
BACKGROUND: The role of surgery for isolated malignant pulmonary nodules in breast cancerpatients remains unclear. METHODS: A total of 1286 consecutive breast cancerpatients with pulmonary nodules detected by thoracic computed tomography (CT) or positron emission tomography (PET)/CT scan at Shanghai Cancer Center, Fudan University, were reviewed. Overall, 147 breast cancerpatients with isolated malignant pulmonary nodules receiving surgery and/or chemotherapy were enrolled in the study. Patients were classified into three groups: patients with primary lung cancer (PLC) receiving surgery (Group 1), patients with lung metastasis receiving surgery (Group 2), and patients with lung metastasis receiving chemotherapy (Group 3). Survival outcomes, including overall survival (OS) and progression-free survival (PFS), were analyzed for patients in all three groups, and prognostic factors for PFS for patients with pulmonary metastasis were evaluated. RESULTS:Patients with PLC receiving surgery had better survival outcomes, including OS and PFS, than patients with lung metastases who received surgical resection. Breast cancerpatients with solitary lung metastasis who received metastasectomy had a significantly better PFS than those who did not; however, no statistically significant difference in OS was observed between the two groups. A multivariate analysis conducted in patients with isolated metastatic breast cancer showed that surgery was an independent factor for better PFS. CONCLUSIONS: Surgery should be considered a valid option for the diagnosis and treatment of breast cancerpatients presenting with isolated malignant lung nodules.