Pleural effusion as a first manifestation of breast cancer

Background: Conventional chest X-ray (chest X-ray) in Dharmais Cancer Hospital emergency room (ER) is still the primary modality to diagnose patients with cancer with dyspnoea complaints. Chest X-ray was also carried out to screen inpatients at the Dharmais Cancer Hospital ER at the beginning of the COVID-19 pandemic in Indonesia. It was essential because patients in the Dharmais Cancer Hospital ER were patients with cancer, with low immunity and a high risk of being exposed to various infections. Thus, the purpose of this study was to determine the characteristics of chest X-rays in patients with cancer at the Dharmais Cancer Hospital ER during the COVID-19 pandemic in February-May 2020. Methods: This was a descriptive study. The population involved was all patients at the Dharmais Cancer Hospital ER who received chest X-ray support, with the inclusion criteria for diagnosing lung cancer, breast cancer, cervical cancer, colorectal cancer, and blood cancer (Leukemia) from February to May 2020. Data analysis employed univariate analysis by utilizing tables and graphs in presenting the data.Results: 289 samples met the research criteria. The highest visits were patients with breast cancer (41.2%). The most common thoracic images were pleural effusion (34.3%), followed by bronchopneumonia (31.1%), normal lung (16.6%), lung mass (7.6%), pneumonia (5.2%), and others (5.2%), consisting of atelectasis, bronchitis, fibrosis/chronic pulmonary process, pulmonary emphysema, cardiomegaly, and specific process. Besides, the chest x-ray bronchopneumonia was 31.1% (90 samples), accompanied by pleural effusion of 44.4%. From the chest X-ray, pleural effusions were 34.3% (99 samples), with lung cancer being the most common with pleural effusions (48.4%).Conclusions: More than 80% of chest x-ray performed in the ER are abnormal. Also, breast cancer is the highest in the Dharmais Cancer Hospital ER cases, with the highest chest x-ray of pleural effusion.

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Establishment and Characterization of a HER2-Positive Cell Line Derived From the Pleural Effusion of a Drug-Resistant Breast Cancer Patient

Frontiers in Cell and Developmental Biology ◽

10.3389/fcell.2021.680968 ◽

2021 ◽

Vol 9 ◽

Author(s):

Zhaoqing Li ◽

Wenying Zhuo ◽

Lini Chen ◽

Xun Zhang ◽

Cong Chen ◽

...

Keyword(s):

Breast Cancer ◽

Pleural Effusion ◽

Cancer Patient ◽

Breast Cancer Patient ◽

Cell Line ◽

Cell Lines ◽

Molecular Subtype ◽

Metastatic Breast ◽

Drug Resistant ◽

Her2 Positive

Drug resistance is a daunting challenge in the treatment of breast cancer, making it an urgent problem to solve in studies. Cell lines are important tools in basic and preclinical studies; however, few breast cell lines from drug-resistant patients are available. Herein, we established a novel HER2-positive breast cancer cell line from the pleural effusion of a drug-resistant metastatic breast cancer patient. This cell line has potent proliferative capability and tumorigenicity in nude mice but weak invasive and colony-forming capability. The molecular subtype of the cell line and its sensitivity to chemotherapeutics and HER2-targeting agents are different from those of its origin, suggesting that the phenotype changes between the primary and metastatic forms of breast cancer.

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Malignant pleural effusion in breast cancer 12 years after mastectomy that was successfully treated with endocrine therapy

American Journal of Case Reports ◽

10.12659/ajcr.889249 ◽

2013 ◽

Vol 14 ◽

pp. 184-187 ◽

Cited By ~ 5

Author(s):

Kiyofumi Yamagishi

Keyword(s):

Breast Cancer ◽

Pleural Effusion ◽

Endocrine Therapy ◽

Malignant Pleural Effusion

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Diagnostic value of cytologic investigation of cell count differential of pleural fluid

Russian Pulmonology ◽

10.18093/0869-0189-2007-0-3-66-71 ◽

2007 ◽

pp. 66-71

Author(s):

O. G. Grigoruk ◽

A. F. Lazarev ◽

L. M. Bazulina

Keyword(s):

Breast Cancer ◽

Pleural Effusion ◽

Cell Count ◽

Pleural Fluid ◽

Lung Carcinoma ◽

Small Cell Lung Carcinoma ◽

Mesothelial Cell ◽

Diagnostic Value ◽

Primary Tumors ◽

Cell Lung Carcinoma

The cell count differential of pleural fluid sample is of great importance for estimation of the nature of pleural effusion. In the present article, we compared the efficiencies of routine cytology method with light microscopy, cytological examination with centrifuge Cytospin-4 and immunocytochemical methods. We have studied cytological samples from 1597 patients, with pleural effusion. Effusions associated with malignancies were reported in 22.7 % of patients including carcinomatosis (74.6 %), primary tumors of pleura (21.5 %), effusions associated with non epithelial malignancies (3.9 %). Benign pleural effusions were reactive (63.6 %), tuberculotic (13.5 %), "cholesterol pleurisy" and chylothorax (0.2 %). Carcinomatous pleuritis was found in patients with lung carcinoma (55.4 %), breast cancer (21.8 %) and ovary cancer (12.2 %). Specific malignant features (direct and indirect) were noted in pleural fluid on breast cancer, carcinomas of ovary, stomach, kidney, small cell lung carcinoma and squamous cell lung carcinoma. These features are hardly detected in patients with malignancies of intestines, prostate and endometria because these types of tumours are rarely metastatic to pleura. We were failed to define particular features of lung adenocarcinoma. The centrifuge Cytospin-4 was used in the most difficult cases (13.5 %) providing minimal number of presumable diagnosis. Primary tumours of pleura are the most difficult for detection. Immunocytochemical analysis found monoclonal mesothelial cell of НВЕМ 1 clone, cytokeratin, vimentin to be positive and carcinoembry onic antigen, Ber-EP4, CD-15 to be negative in the studied tumors.

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F-18 fluorodeoxyglucose positron emission computed tomography in the diagnosis of pleural metastases from breast carcinoma

International Surgery Journal ◽

10.18203/2349-2902.isj20200819 ◽

2020 ◽

Vol 7 (3) ◽

pp. 764

Author(s):

Murat Saricam

Keyword(s):

Breast Cancer ◽

Computed Tomography ◽

Pleural Effusion ◽

Emission Computed Tomography ◽

Pleural Effusions ◽

Fdg Uptake ◽

Positron Emission ◽

Pet Ct ◽

Positron Emission Computed Tomography ◽

Pleural Metastases

Background: This study aimed to investigate the feasibility of F-18 fluorodeoxyglucose (FDG) positron emission computed tomography (PET/CT) in identifying the pleural invasion of metastatic breast cancers.Methods: A retrospective study was conducted to include 75 patients with untreated breast cancer who had undergone thoracoscopy to drain pleural effusions and to perform pleural biopsies. Whole group of patients were evaluated in terms of age, type of primary breast cancer, macroscopic appearance of pleura during thoracoscopy, maximum standardized FDG uptake value (SUV) reported by PET/CT scan in addition to presence of malignancy detected in pleura and/or pleural effusion.Results: All of 75 patients were female and mean age was 56.12±11.70. Metastatic disease was diagnosed in the pleura of 40 (53.3%) and in the pleural effusion of 43 (57.3%) patients. The sensitivity and specificity of PET/CT in detecting pleural metastases of breast carcinoma was calculated as 88.2% and 96.2% whereas PET/CT demonstrated sensitivity of 91.9% and specificity of 91.3% in identifying malignant pleural effusion. Cut-off values of FDG uptake were 4.25 for pleural metastases and 3.85 for malignant pleural effusions. PET/CT also indicated a false negative rate of 12.5%, a false positive rate of 16.28% and an overall accuracy rate of 85.33% in the diagnosis of pleural metastasis of breast carcinoma.Conclusions: PET/CT reporting an FDG uptake over 4 in the pleura or pleural effusion is beneficial in managing the patients with the suspicion of pleural metastases from breast cancer.

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THERAPIES OF RESISTANT EXUDATIVE PLEURITIS

Ulyanovsk Medico-biological Journal ◽

10.34014/2227-1848-2020-1-22-30 ◽

2020 ◽

pp. 22-30

Author(s):

A.L. Charyshkin ◽

E.A. Kuzmina ◽

B.I. Khusnutdinov ◽

E.A. Toneev ◽

O.V. Midlenko ◽

...

Keyword(s):

Breast Cancer ◽

Lung Cancer ◽

Ovarian Cancer ◽

Pleural Effusion ◽

Malignant Pleural Effusion ◽

Pleural Cavity ◽

Pleural Empyema ◽

Malignant Neoplasms ◽

Risk Of Infection ◽

Minimally Invasive Methods

In Russia, annually more than 100,000 people are diagnosed with tumor pleuritis. Resistant cancerous pleuritis is often caused by lung cancer (35 %), breast cancer (23 %), ovarian cancer and lymphomas (10 %). Pleuritis in malignant neoplasms often indicates the spread of the process through pleura. At the same time, systemic therapy does not always help patients. Radical treatment for malignant pleural effusion is gradually being replaced by new minimally invasive methods. Prolonged drainage of the pleural cavity in exudative pleuritis increases the risk of infection, which contributes to the development of pleural empyema. In order to eliminate the exudate, talc, tetracycline, and Betadine solutions are introduced into the pleural cavity through the drainage, the efficacy being 60 to 90 %. Thus, a new method for drug administration into the pleural cavity, which helps to eliminate resistant exudative pleuritis, remains relevant. Keywords: resistant exudative pleuriris, malignant neoplasms, pleurodesis. Проведен обзор отечественной и зарубежной литературы, посвященный местному лечению резистентного злокачественного плеврита. С каждым годом частота онкологических заболеваний и опухолевых плевритов только повышается. В России ежегодно опухолевые плевриты диагностируют более чем у 100 000 чел. Резистентный злокачественный плеврит в 35 % случаев обусловлен раком легкого, в 23 % – раком молочной железы, в 10 % – раком яичников и лимфомами. Плеврит при злокачественных новообразованиях часто свидетельствует о распространении процесса по плевре. При этом использование системных методов лечения не всегда облегчает состояние пациента. Радикальные методы лечения злокачественного плеврального выпота постепенно заменяются новыми минимально инвазивными методами. Продолжительное дренирование плевральной полости при экссудативном плеврите увеличивает риск ее инфицирования, что способствует развитию эмпиемы плевры. С целью ликвидации экссудата через установленный дренаж в плевральную полость вводят растворы талька, тетрациклина, бетадина с эффективностью от 60 до 90 %. Недостатком данного способа лечения является выраженный болевой синдром, повышение температуры тела, риск легочных осложнений, длительность лечения. Таким образом, создание способа введения лекарственных препаратов в плевральную полость для ликвидации резистентного экссудативного плеврита остается актуальным. Ключевые слова: резистентный экссудативный плеврит, злокачественные новообразования, плевродез.

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Rapid and prolonged palliation of symptoms with improved quality of life (QOL) with endocrine therapy (anastrazole) in metastatic breast cancer (MBC)

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.10767 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 10767-10767

Author(s):

J. Samuel ◽

D. Osafo

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Lymph Node ◽

Pleural Effusion ◽

Endocrine Therapy ◽

Primary Breast Cancer ◽

Metastatic Breast ◽

Electrolyte Imbalance ◽

Axillary Lymphadenopathy ◽

Post Menopausal

10767 Background: Efficacy of anastrazole in receptor positive post-menopausal MBC; rapid palliation of symptoms with improved QOL. Methods: Case Report: A 62 year old woman diagnosed with right breast cancer in 1995, stage IIB, underwent surgery, adjuvant chemotherapy, and tamoxifen for 5 years. In February 2004, a left supraclavicular lymph node (1 cm) was felt. Chest x-ray (CXR) showed blunting of right cardiophrenic angle. CT scan of the neck showed multiple left cervical lymph nodes. In April 2004, her condition deteriorated rapidly needing hospitalization. She developed 15 pound weight loss, anemia, anorexia, shortness of breath, dyspnea on exertion, dry cough, and chest pain. CXR showed large right pleural effusion needing multiple thoracentesis. Hemorrhagic exudative effusion was seen with negative cytology and cultures. She also developed multiple palpable left cervical and left axillary lymphadenopathy. Breast exam was normal. Mammogram was not diagnostic but ultrasound of breast showed a 2.5cm left breast mass, axillary lymphadenopathy and additional lesions in the breast. Left cervical lymph node biopsy showed metastatic adenocarcinoma favoring primary breast cancer. A diagnosis of 2nd primary breast cancer with metastasis was made. Within 1 week of palliative capecitabine, she was readmitted with significant mucositis, diarrhea, dehydration, dysphagia, electrolyte imbalance, and reaccumulation of right pleural effusion. She lost 35 lbs. in 4 months. She was aggressively resuscitated and also needed thoracocentesis. Markers from prior biopsy showed Estrogen receptor 20%, Progesterone receptor <5%, and HER 2 (Herceptest) 3+. Palliative hormonal therapy with anastrazole was started in July 2004. Results: Within 4 weeks, she improved significantly with disappearance of lymphadenopathy and resolution of effusion. Performance status improved to ECOG 0. She is continuing anastrazole, 17 months since the diagnosis of debilitating metastatic breast cancer. Conclusions: Anastrazole is approved for the treatment of hormone receptor positive post-menopausal MBC. We describe the efficacy of endocrine therapy (anastrazole) leading to rapid and meaningful palliation of symptoms with improved QOL. No significant financial relationships to disclose.

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