Skip to main content

Management of Discrete Pulmonary Nodules

  • Chapter
  • First Online:
Breast Disease

Abstract

In the case of a pulmonary nodule on preoperative examination or during postoperative follow-up of breast cancer patients, it can be difficult to distinguish between primary lung cancer, a metastatic pulmonary tumor, and a benign pulmonary lesion. The size, morphology, and number of nodules are helpful parameters for differential diagnoses in many cases, whereas more interventional methods are required to clarify the etiology of progression at follow-up. Benign lesions such as atypical pneumonia, tuberculosis, atypical mycobacteria, inflammatory granuloma, rheumatoid nodules, and atypical bronchoalveolar hyperplasia are also common in immunocompromised patients who underwent multiple cycles of chemotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Jung JI, Kim HH, Park SH, Song SW, Song SW, Chung MH, Kim HS, et al. Thoracic manifestations of breast cancer and its therapy. Radiographics. 2004;24:1269–85.

    Article  PubMed  Google Scholar 

  2. Khatcheressian JL, Hurley P, Bantug E, Esserman LJ, Grunfeld E, Halberg F, et al. Breast cancer follow-up and management after primary treatment: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31:961–5.

    Google Scholar 

  3. Rashid OM, Takabe K. The evolution of the role of surgery in the management of breast cancer lung metastasis. J Thorac Dis. 2012;4:420–4.

    PubMed  PubMed Central  Google Scholar 

  4. Rusch VW. Pulmonary metastasectomy. Current indications. Chest. 1995;107:322S–31.

    Article  CAS  PubMed  Google Scholar 

  5. Detterbeck FC, Grodzki T, Gleeson F, Robert JH. Imaging requirements in the practice of pulmonary metastasectomy. J Thorac Oncol. 2010;5:S134–9.

    Article  PubMed  Google Scholar 

  6. Nichols FC. Pulmonary metastasectomy. Thorac Surg Clin. 2012;22:91–9.

    Article  PubMed  Google Scholar 

  7. Rena O, Papalia E, Ruffini E, Filosso PL, Oliaro A, Maggi G, et al. The role of surgery in the management of solitary pulmonary nodule in breast cancer patients. Eur J Surg Oncol. 2007;33:546–50.

    Article  CAS  PubMed  Google Scholar 

  8. Tanaka F, Li M, Hanaoka N, Bando T, Fukuse T, Hasegawa S, et al. Surgery for pulmonary nodules in breast cancer patients. Ann Thorac Surg. 2005;79:1711–4; discussion 1714–1715.

    Article  PubMed  Google Scholar 

  9. Endri M, Cartei G, Zustovich F, Serino FS, Fassina A. Differential diagnosis of lung nodules: breast cancer metastases and lung tuberculosis. Infez Med. 2010;1:39–42.

    Google Scholar 

  10. Ou KW, Hsu KF, Cheng YL, Hsu GC, Hsu HM, Yu JC. Asymptomatic pulmonary nodules in a patient with early-stage breast cancer: Cryptococcus infection. Int J Infect Dis. 2010;14:e77–80.

    Article  PubMed  Google Scholar 

  11. Kaplan MH, Armstrong D, Rosen P. Tuberculosis complicating neoplastic disease: a review of 201 cases. Cancer. 1974;33:850–8.

    Article  CAS  PubMed  Google Scholar 

  12. Kreisman H, Wolkove N, Finkelstein HS, Cohen C, Margolese R, Frank H. Breast cancer and thoracic metastases: review of 119 patients. Thorax. 1983;38:175–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Connolly Jr JE, Erasmus JJ, Patz Jr EF. Thoracic manifestations of breast carcinoma: metastatic disease and complications of treatment. Clin Radiol. 1999;54:487–94.

    Article  PubMed  Google Scholar 

  14. Lee B, Lim A, Lalvani A, Deschamps MJ, Leonard R, Nallamala S, et al. The clinical significance of radiologically detected silent pulmonary nodules in early breast cancer. Ann Oncol. 2008;19:2001–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Evangelista L, Panunzio A, Cervino AR, Vinante L, Al-Nahhas A, Rubello D, Muzzio PC, Polverosi R. Indeterminate pulmonary nodules on CT images of breast cancer patient: the additional value of 18F-FDG PET-CT. J Med Imaging Radiat Oncol. 2012;56:417–24.

    Article  PubMed  Google Scholar 

  16. Park JS, Choi DH, Huh SJ, Park W, Nam SJ, Lee JE, Kil WH, Lee KS. Incidental findings on simulation CT images for adjuvant radiotherapy in breast cancer patients. Technol Cancer Res Treat. 2015;14:525–9.

    Google Scholar 

  17. Chang EY, Johnson W, Karamlou K, Khaki A, Komanapalli C, Walts D, Mahin D, Johnson N. The evaluation and treatment implications of isolated pulmonary nodules in patients with a recent history of breast cancer. Am J Surg. 2006;191:641–5.

    Article  PubMed  Google Scholar 

  18. Seo JB, Im J, Goo JM, Chung MJ. Atypical pulmonary metastases: spectrum of radiologic findings. RadioGraphics. 2001;21:403–17.

    Article  CAS  PubMed  Google Scholar 

  19. Kinoshita T, Yoshida J, Ishii G, Hishida T, Wada M, Aokage K, et al. The availability of pre- and intraoperative evaluation of a solitary pulmonary nodule in breast cancer patients. Ann Thorac Cardiovasc Surg. 2015;21:31–6.

    Article  PubMed  Google Scholar 

  20. Okasaka T, Usami N, Mitsudomi T, Yatabe Y, Matsuo K, Yokoi K. Stepwise examination for differential diagnosis of primary lung cancer and breast cancer relapse presenting as a solitary pulmonary nodule in patients after mastectomy. J Surg Oncol. 2008;98:510–4.

    Article  PubMed  Google Scholar 

  21. Kim H, Han W, Moon HG, Min J, Ahn SK, Kim TY, et al. The value of preoperative staging chest computed tomography to detect asymptomatic lung and liver metastasis in patients with primary breast carcinoma. Breast Cancer Res Treat. 2011;126:637–41.

    Article  CAS  PubMed  Google Scholar 

  22. Moldvay J, Jackel M, Bogos K, Soltesz I, Agocs L, Kovacs G, et al. The role of TTF-1 in differentiating primary and metastatic lung adenocarcinomas. Pathol Oncol Res. 2004;10:85–8.

    Article  CAS  PubMed  Google Scholar 

  23. Kitada M, Sato K, Matsuda Y, Hayashi S, Miyokawa N, Sasajima T. Role of treatment for solitary pulmonary nodule in breast cancer patients. World J Surg Oncol. 2011;9:124.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Kycler W, Laski P. Surgical approach to pulmonary metastases from breast cancer. Brest J. 2012;18:52–7.

    Article  Google Scholar 

  25. Staren ED, Salerno C, Rangione A. Pulmonary resection for metastatic breast cancer. Arch Surg. 1992;127:1282–4.

    Article  CAS  PubMed  Google Scholar 

  26. Mc Donald ML, Deschamps C, Ilstrup DM. Pulmonary resection for metastatic breast cancer. Ann Thorac Surg. 1994;58:1599–602.

    Article  CAS  Google Scholar 

  27. Friedel G, Pastorino U, Ginsberg RJ. Results of lung metastasectomy from breast cancer: prognostic criteria on the basis of 467 cases of the International Registry of Lung Metastases. Eur J Cardiothorac. 2002;22:335–44.

    Article  Google Scholar 

  28. Hanrahan EO, Broglio KR, Buzdar AU, Theriault RL, Valero V, Cristofanilli M, et al. Combined-modality treatment for isolated recurrences of breast carcinoma: update on 30 years of experience at the University of Texas M.D. Anderson Cancer Center and assessment of prognostic factors. Cancer. 2005;104:1158–71.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sukru Dilege MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Dilege, S., Bayrak, Y., Tanju, S. (2016). Management of Discrete Pulmonary Nodules. In: Aydiner, A., Ä°gci, A., Soran, A. (eds) Breast Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-26012-9_40

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-26012-9_40

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26010-5

  • Online ISBN: 978-3-319-26012-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics