Management of malignant pleural effusion secondary to breast cancer: talc pleurodesis and pleuroperitoneal shunting.

Malignant pleural effusion is a frequent complication of metastatic breast cancer, leading to a significant degree of morbidity. Drainage of the effusion by thoracocentesis and subsequent pleurodesis is an established means of symptomatic relief in these patients. Several sclerosing agents have been reported in the literature, including doxycylin, minocyclin, tetracyclines, bleomycin, cisplatin, etoposide, fluorouracil, interferon-beta, Corynebacterium parvum, and talc which gives the best results. The condition of the lung's parenchyma must be evaluated prior to the procedure to rule out lymphangitis carcinomatosa or bronchial obstruction that would impair the expansion of the lung. In these situations, the implantation of a pleuroperitoneal shunt is an alternative to be considered.