A New Isolated Mediastinal Lymph Node or Small Pulmonary Nodule Arising during Breast Cancer Surveillance Following Curative Surgery: Clinical Factors That Differentiate Malignant from Benign Lesions.
- Author:
Tae Yong KIM
1
;
Kyung Hun LEE
;
Sae Won HAN
;
Do Youn OH
;
Seock Ah IM
;
Tae You KIM
;
Wonshik HAN
;
Kyubo KIM
;
Eui Kyu CHIE
;
In Ae PARK
;
Young Tae KIM
;
Dong Young NOH
;
Sung Whan HA
;
Yung Jue BANG
Author Information
1. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. ktyongmd@gmail.com
- Publication Type:Original Article
- Keywords:
Breast neoplasms;
Pulmonary nodule;
Mediastinal lymph node;
Neoplasm metastasis;
Benign
- MeSH:
Breast Neoplasms*;
Diagnosis;
Humans;
Lymph Nodes*;
Mediastinoscopy;
Neoplasm Metastasis;
Positron-Emission Tomography;
Thoracic Surgery, Video-Assisted;
Thoracotomy
- From:Cancer Research and Treatment
2014;46(3):280-287
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: A newly isolated mediastinal lymph node (LN) or a small pulmonary nodule, which appears during breast cancer surveillance, may pose a diagnostic dilemma with regard to malignancy. We conducted this study to determine which clinical factors were useful for the differentiation of malignant lesions from benign lesions under these circumstances. MATERIALS AND METHODS: We enrolled breast cancer patients who were presented with a new isolated mediastinal LN or small pulmonary nodule that arose during surveillance, and whose lesions were pathologically confirmed. Tissue diagnosis was made by mediastinoscopy, video-assisted thoracic surgery or thoracotomy. RESULTS: A total of 43 patients were enrolled (mediastinal LN, 13 patients; pulmonary nodule, 30 patients). Eighteen patients (41.9%) were pathologically confirmed to have a benign lesion (benign group), and 25 patients (58.1%) were confirmed to have malignant lesion (malignant group). Between the two groups, the initial tumor size (p=0.096) and N stage (p=0.749) were similar. Hormone receptor negativity was more prevalent in the malignant group (59.1% vs. 40.9%, p=0.048). The mean lesion size was larger in the malignant group than in the benign group (20.8 mm vs. 14.4 mm, p=0.024). Metastatic lesions had a significantly higher value of maximal standardized uptake (mSUV) than that of benign lesions (6.4 vs. 3.4, p=0.021). CONCLUSION: Hormone receptor status, lesion size, and mSUV on positron emission tomography are helpful in the differentiation of malignant lesions from benign lesions in breast cancer patients who were presented with a new isolated mediastinal LN or small pulmonary nodule during surveillance.
