The utility of EUS-guided FNA in the diagnosis of metastatic breast cancer to the esophagus and the mediastinum.
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.
Sobel
Jason M
JM
Department of Internal Medicine, St. Joseph Mercy Hospital, Ann Arbor, MI 48106, USA.
Lai
Rebecca
R
Mallery
Shawn
S
Levy
Michael J
MJ
Wiersema
Maurits J
MJ
Greenwald
Bruce D
BD
Gunaratnam
Naresh T
NT
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