Department of Thoracic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.
Department of Thoracic Surgery, Jimo District Qingdao Hospital of Traditional Chinese Medicine, Shandong, 266200, China.
J Cardiothorac Surg. 2022 Jun 18;17(1):160. doi: 10.1186/s13019-022-01898-4.
Isolated malignant pulmonary nodules were frequently seen in patients with breast cancer. These were metastasis from the breast cancer or new primary lung cancer. The role of surgery for such pulmonary nodules remains unclear.
A total of 90 patients who underwent surgery for solitary malignant pulmonary nodules between January 2010 and April 2018 after curative operation for breast cancer were reviewed.
The pathologic diagnoses revealed 63 patients with primary lung cancer (PLC) and 27 patients with pulmonary metastatic breast cancer (MBC), which were divided into two groups. All patients were female with a mean age of 55.08 ± 9.84 years (range 31-75). Age differences between the two groups were insignificant. Of the 63 patients with PLC, 55(87%) had a lobectomy with lymphadenctomy and 8(13%) had a limited resection, while the majority of patients (78%) with MBC had a limited resection. All nodules were adenocarcinomas and their mean diameter was 1.63 ± 0.57 cm. 7/55 of patients with PLC had N1 disease while 3/6 of those with MBC had involvement of N1 nodes. For all patients, the overall survival (OS) was 86.1% at 5 years and the disease-free survival (DFS) was 86.0% at 5 years. Patients with PLC had the better surgical outcomes including OS and DFS than those with MBC did (94.2% vs. 72.8%, p = 0.017; 93.6% vs. 63.9%, p = 0.002).
Surgical outcomes of isolated malignant pulmonary nodules in breast cancer patients were favorable. Surgery should be considered as an option for breast cancer patients with isolated pulmonary nodules.
乳腺癌患者常可见孤立性肺恶性结节，这些结节可能是乳腺癌转移或新的原发性肺癌。对于此类肺部结节，手术的作用尚不清楚。
回顾性分析 2010 年 1 月至 2018 年 4 月期间，90 例经乳腺癌根治术后因孤立性恶性肺结节而行手术治疗的患者。
病理诊断为原发性肺癌（PLC）63 例，肺转移性乳腺癌（MBC）27 例，分为两组。所有患者均为女性，平均年龄 55.08±9.84 岁（范围 31-75 岁）。两组患者年龄差异无统计学意义。63 例 PLC 患者中，55 例（87%）行肺叶切除术加淋巴结清扫术，8 例（13%）行局限性切除术，而大多数 MBC 患者（78%）行局限性切除术。所有结节均为腺癌，平均直径为 1.63±0.57cm。7/55 例 PLC 患者有 N1 疾病，而 3/6 例 MBC 患者有 N1 淋巴结受累。所有患者 5 年总生存率（OS）为 86.1%，无病生存率（DFS）为 86.0%。PLC 患者的 OS 和 DFS 均优于 MBC 患者（94.2%比 72.8%，p=0.017；93.6%比 63.9%，p=0.002）。
乳腺癌患者孤立性肺恶性结节的手术结果良好。对于孤立性肺结节的乳腺癌患者，手术应作为一种选择。
