Cao Liyu, Lv Liting
Department of Medical Oncology.
Department of Oncology Surgery, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.
Medicine (Baltimore). 2020 Dec 4;99(49):e23503. doi: 10.1097/MD.0000000000023503.
Lung adenocarcinoma is the most common type of lung cancer. Distant metastasis of lung adenocarcinoma often occurs in multiple organs. The common metastasis sites of lung cancer include the lungs, brain, bones, adrenal glands, and lymph nodes; however, breast metastasis is rare.
In this report, we describe a case of breast metastasis from lung adenocarcinoma. A 55-year-old woman reported left breast pain for more than 1 month.
Based on imaging, pathological examination, and immunohistochemical examination, the diagnosis of breast metastasis from lung adenocarcinoma was confirmed. Epidermal growth factor receptor mutations and anaplastic lymphoma kinase rearrangement were not detected by next-generation sequencing.
The patient was treated with six courses of a combination of albumin-bound paclitaxel, cisplatin, and bevacizumab over 21 days.
After six cycles of palliative chemotherapy, her left breast pain and swelling subsided; in addition, her serum CA12-5, CYFRA, and CEA levels normalized by April 2019. PR status was evaluated as per the RECIST 1.1 criteria. The patient developed brain metastases 3 months later and died due to multiple organ failure.
The possibility of breast metastasis should be considered in patients with existing malignant tumors and breast pain. Clinical and imaging examinations are helpful for diagnosis, and pathological and immunohistochemical analyses are the most important diagnostic tools.
肺腺癌是肺癌最常见的类型。肺腺癌的远处转移常发生于多个器官。肺癌常见的转移部位包括肺、脑、骨、肾上腺和淋巴结;然而,转移至乳腺的情况较为罕见。
在本报告中,我们描述了一例肺腺癌转移至乳腺的病例。一名55岁女性报告左侧乳房疼痛超过1个月。
基于影像学、病理检查和免疫组化检查,确诊为肺腺癌转移至乳腺。二代测序未检测到表皮生长因子受体突变和间变性淋巴瘤激酶重排。
患者接受了6个疗程的白蛋白结合型紫杉醇、顺铂和贝伐单抗联合治疗,为期21天。
经过6个周期的姑息化疗,她左侧乳房的疼痛和肿胀消退;此外,到2019年4月,她的血清CA12-5、细胞角蛋白片段抗原21-1(CYFRA)和癌胚抗原(CEA)水平恢复正常。根据实体瘤疗效评价标准(RECIST)1.1版评估为部分缓解(PR)状态。3个月后患者发生脑转移,最终因多器官功能衰竭死亡。
对于已有恶性肿瘤且出现乳房疼痛的患者,应考虑乳腺转移的可能性。临床和影像学检查有助于诊断,而病理和免疫组化分析是最重要的诊断工具。