The evaluation and treatment implications of isolated pulmonary nodules in patients with a recent history of breast cancer

BACKGROUND: Breast cancer patients with pulmonary lesions are often assumed to have metastatic disease and treated palliatively. We evaluated the proportion of these patients who actually have primary lung tumor (PLT) and assessed their outcome. METHODS: We performed a 10-year retrospective review of the cancer registry in a community hospital system. RESULTS: Among 54 breast cancer patients with pulmonary nodules, biopsy was pursued in 30. Although metastatic breast cancer (MBC) was presumed in 24, biopsy showed MBC in 9 patients and PLT in 21. The two groups differed in age, stage, breast tumor size, nodal involvement, and estrogen receptor (ER) positivity. However, no variable excluded the possibility of PLT. Of those with PLT, 11 had early-stage lung disease; 9 underwent curative resection. CONCLUSIONS: Women with breast cancer and 1 or more pulmonary lesions without evidence of other metastatic disease require work-up of pulmonary lesions. Aggressive evaluation can afford treatment of lung cancer and impact survival.