Eur J Breast Health, cilt.17, sa.2, ss.200-205, 2020 (Hakemli Dergi)
THREE CASES OF BREAST METASTASES FROM LUNG CANCER AND SYSTEMATIC
REVIEW OF THE LITERATURE
Abstract:
Metastatic
involvement of the breast tissue from extramammary sites is very rare with an
incidence of 0.4 -1.3 %. Despite the high rate of lung cancer among other
primary tumors, metastasis of this common malignancy to the breast is very
rare. We have performed a
systematic review of the literature and found 258 cases published up to 2019 in English literature.
We report 3 new
cases of lung cancer with breast metastases. Two were small cell lung cancer
and one was an adenocarcinoma. Both breasts were affected in one case and the
left breast in the other two cases. They were multiple in two cases and single
in one case. Radiologically each case displayed different features. One of them had
bilateral superficially and deeply located multiple irregular lesions, some of
which were hyperechoic. Some also had echogenic halo around them, which is rare
in metastatic tumors. Our second patient presented with findings similar to
inflammatory breast cancer, such as skin and trabecular thickenning, redness
over the skin and subcutaneous edema. This type of metastasis has been
associated with lymphatic spread of the primary lung cancer in literature. Our
third case had a circumscribed mass, resembling a benign complicated cyst.
Presence of additional sites of metastases, pleural effusion and lack of
spiculation and calcification were the common features in our cases. All patients
died within 7-16 months after diagnosis of breast metastases.
Differentiating between
metastatic and primary breast cancers is important in order to avoid
unnecessary surgical procedures.
Clinical history, imaging findings and immunohistochemistry may help
diagnosis when used in combination. Radiologists should be aware of
the spectrum of typical and atypical imaging findings of metastatic involvement
of the breast to guide the clinicians for appropriate patient management.