title: Role of treatment for solitary pulmonary nodule in breast cancer patients.
abstract: BACKGROUND
  Metastatic pulmonary tumors secondary to breast cancer detected either before or after surgery are predominantly multiple and bilateral. However, in cases detected to have a solitary pulmonary nodule (SPN), determining whether the lesion represents a primary cancer, metastasis, or a benign pulmonary lesion can be difficult.
  
  
  METHODS
  Between January 2000 and December 2009, we performed breast cancer surgery on 1,226 patients, of which 49 cases (3.9%) were detected to have pulmonary lesions before or after the surgery. In 14 of these patients, video-assisted thoracoscopic surgery was performed to remove a SPN.
  
  
  RESULTS
  Pathological examination of the resected specimens in these 14 cases revealed metastatic pulmonary tumor in 8 cases, primary lung cancer in 3 cases, and benign disease in 3 cases. While lobectomy was performed in one of these patients with metastatic pulmonary tumor, the remaining 7 underwent partial resection of the lung. The primary lung cancer was an adenocarcinoma in all 3 patients, and lobectomy plus mediastinal lymph node dissection was performed in these patients. The tumor grading based on pathological diagnosis was T1N0M0, p-Stage 1A in all 3 patients. The prognosis was good in the breast cancer patients in whom the metastatic lung tumor was a SPN.
  
  
  CONCLUSIONS
  Evaluating the immunohistochemical cytokeratin profile and levels of the TTF-1 and GCDFP-15 of the lesion was useful when distinguishing between pulmonary cancer and metastatic pulmonary tumor. In addition, some patients exhibited changes in the biological properties of the metastatic tumor, and delete tumor resection by video-assisted thoracoscopic surgery can be useful for deciding the drug treatment strategy in some cases.
authors: Department of Surgery, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1 Asahikawa Hokkaido 078-8510, Japan. k1111@asahikawa-med.ac.jp
authors: Masahiro
authors: M
authors: Kitada
authors: Kazuhiro
authors: K
authors: Sato
authors: Yoshinari
authors: Y
authors: Matsuda
authors: Satoshi
authors: S
authors: Hayashi
authors: Naoyuki
authors: N
authors: Miyokawa
authors: Tadahiro
authors: T
authors: Sasajima
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007633:Keratins / Q000378:metabolism; D008175:Lung Neoplasms / Q000150:complications / Q000556:secondary* / Q000601:surgery; D008197:Lymph Node Excision; D008408:Mastectomy; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D007633:Keratins