Surgery for pulmonary nodules in breast cancer patients
Surgery for pulmonary nodules in breast cancer patients
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DOI：
10.1016/j.athoracsur.2004.10.033
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发表时间：
2005-05-01
影响因子：
4.6
通讯作者：
Wada, H
中科院分区：
文献类型：
--
作者：
Tanaka, F;Li, M;Wada, H
背景资料。接受乳腺癌手术的患者中出现的肺结节的性质以及手术在此类肺结节中的作用尚不清楚。对1992-2001年间连续52例乳腺癌根治性手术后行肺结节手术的患者进行回顾分析。病理诊断为乳腺癌肺转移39例，原发肺癌6例，其他7例(结核、错构瘤各2例，硬化性血管瘤、机化性肺炎、并殖吸虫病各1例)。转移性乳腺癌患者多发肺结节的发生率(64.1%)明显高于原发肺癌患者(33.3%)和其他组织学患者(28.6%)。转移性乳腺癌患者首次乳房切除术后的平均无病间隔时间(66.8个月)明显缩短，但41.0%的转移性乳腺癌患者的无病间隔时间长于5年。转移性乳腺癌患者肺转移切除术后5年生存率为30.8%，并不优于现代化疗的转移性乳腺癌患者。根据肺转移的数目或部位或无瘤间隔的不同，手术后的生存率无显著差异。肺转移切除术可能不是转移性乳腺癌患者的主要治疗选择，患者应该主要接受化疗。由于乳腺癌患者出现的肺结节并不一定都是肺转移瘤，病理诊断应予以确认，手术是病理确诊的一种选择。©2005，由胸科外科医生学会主办。
Background. The nature of pulmonary nodules that appeared in patients who had received surgery for breast cancer, as well as the role of surgery for such pulmonary nodules, remains unclear.Methods. A total of 52 consecutive patients who underwent surgery for pulmonary nodules between 1992 and 2001 after curative operation for breast cancer were reviewed.Results. The pathologic diagnoses of pulmonary nodules were pulmonary metastases of breast cancer in 39 patients, primary lung cancer in 6, and other diagnoses in 7 (tuberculosis and hamartoma in 2 each; sclerosing hemangioma, organizing pneumonia, and paragohimiasis in 1 each). The incidence of multiple pulmonary nodules was significantly higher in metastatic breast cancer patients (64.1%), but 33.3% of primary lung cancer patients and 28.6% of other histology patients had multiple pulmonary nodules. The average disease-free interval from the initial mastectomy was significantly shorter in metastatic breast cancer patients (66.8 months), but disease-free intervals were longer than 5 years in 41.0% of metastatic breast cancer patients. The 5-year survival rate after pulmonary metastectomy of metastatic breast cancer patients was 30.8%, which was not better than those documented in metastatic breast cancer patients treated with modern chemotherapy. There was no significant difference in postmetastectomy survival according to the number or sites of pulmonary metastases or the disease-free interval.Conclusions. Pulmonary metastectomy may not be the primary therapeutic option in metastatic breast cancer patients, and patients should be treated principally with chemotherapy. As pulmonary nodules that appear in breast cancer patients are not always pulmonary metastases, the pathologic diagnosis should be confirmed, and surgery is an option for the pathologic confirmation. © 2005 by The Society of Thoracic Surgeons.