title: Diagnosis and surgical resection of solitary pulmonary nodules in patients with breast cancer.
abstract: The differential diagnosis of solitary pulmonary nodules (SPNs) using radiological features in patients with breast cancer is vital yet difficult. The nature of SPNs, of these patients, as well as the role of surgery in the diagnosis and treatment were evaluated. Thirty consecutive patients, who underwent surgery for an SPN between 2002 and 2011 subsequent to curative surgery for breast cancer were retrospectively evaluated. The overall survival and disease-free survival periods were estimated using the Kaplan-Meier method. The Student's t-test and the χ2test were performed to compare percentages and the mean values, respectively. The values were considered statistically significant at P<0.05. Most (93%) SPNs were malignant. The pathological diagnoses in patients with SPNs were primary lung cancer (n=20, 67%), pulmonary metastasis from breast (n=7, 23%) or colon (n=1, 3%) cancers and benign conditions (n=2, 7%). Of the 20 patients with primary lung cancer, 15 (75%) had stage IA tumors (T1aN0M0). The average disease-free interval was significantly longer in patients with primary lung cancer compared to patients with pulmonary metastases from breast cancer (P= 0.031). The five-year survival rates after pulmonary resection for lung metastasis from breast cancer patients and primary lung cancer patients were 100 and 61.1%, respectively. SPNs found in patients with breast cancer were found to have a high probability of malignancy, especially primary lung adenocarcinoma. The early resection of SPNs in patients diagnosed with both primary and metastatic lung cancer led to a good prognosis. The early pathological diagnosis by surgical resection was suggested to be conducted for the early diagnosis and appropriate treatment of SPNs in patients with breast cancer.
authors.affiliation: Division of Thoracic and Visceral Organ Surgery;
authors.forename: Kazumi
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Division of Thoracic and Visceral Organ Surgery;
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Division of Thoracic and Visceral Organ Surgery;
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ohtaki
authors.affiliation: Division of Thoracic and Visceral Organ Surgery;
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Nakano
authors.affiliation: Division of Thoracic and Visceral Organ Surgery;
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kamiyoshihara
authors.affiliation: Department of Medicine and Molecular Science and.
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Kaira
authors.affiliation: Division of Thoracic and Visceral Organ Surgery;
authors.forename: Nana
authors.initials: N
authors.lastname: Rokutanda
authors.affiliation: Division of Thoracic and Visceral Organ Surgery;
authors.forename: Jun
authors.initials: J
authors.lastname: Horiguchi
authors.affiliation: Division of Diagnostic Pathology, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan.
authors.forename: Tetsunari
authors.initials: T
authors.lastname: Oyama
authors.affiliation: Division of Thoracic and Visceral Organ Surgery;
authors.forename: Izumi
authors.initials: I
authors.lastname: Takeyoshi
keywords: breast cancer; metastasectomy; primary lung cancer; solitary pulmonary nodule; surgery; video-assisted thoracoscopic surgery