title: The utility of EUS-guided FNA in the diagnosis of metastatic breast cancer to the esophagus and the mediastinum.
abstract: BACKGROUND
  Breast cancer can metastasize to the esophagus and the mediastinum. EUS-guided FNA (EUS-FNA) is being used increasingly as a less invasive alternative to mediastinoscopy for procuring a tissue diagnosis of mediastinal disease and may be useful for the diagnosis of breast cancer metastatic to the esophagus and the mediastinum.
  
  
  METHODS
  Twelve women (age range 54-82 years) with a history of breast cancer presented with dysphagia or other symptoms between 1 and 15 years after initial diagnosis and treatment. CT and endoscopy with biopsies suggested a mediastinal mass or lymphadenopathy with extrinsic esophageal compression but failed to provide a tissue diagnosis. EUS-FNA was performed for diagnosis.
  
  
  RESULTS
  Cytologic evaluation of specimens obtained by EUS-FNA confirmed breast cancer metastases in 11 of 12 patients (91%). Recurrent disease was found in intramural masses and periesophageal lymph nodes. No complication resulted from any EUS-FNA procedure.
  
  
  CONCLUSIONS
  EUS-FNA is safe and effective for the diagnosis of breast cancer metastases to the esophagus and the mediastinum. EUS-FNA may be useful as a first-line method of evaluation when breast cancer metastasis to the esophagus and the mediastinum is suspected.
authors.affiliation: Department of Internal Medicine, St. Joseph Mercy Hospital, Ann Arbor, MI 48106, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Sobel
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lai
authors.forename: Shawn
authors.initials: S
authors.lastname: Mallery
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Levy
authors.forename: Maurits J
authors.initials: MJ
authors.lastname: Wiersema
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Greenwald
authors.forename: Naresh T
authors.initials: NT
authors.lastname: Gunaratnam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology*; D019160:Endosonography; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D005260:Female; D006801:Humans; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism*; D008875:Middle Aged