Prognostic Implication of Isolated Pulmonary Nodules in Patients with a History of Breast Cancer

Background: 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.Methods: 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.Results: 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±0.57cm. 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% versus 72.8%, p=0.017; 93.6% versus 63.9%, p=0.002).Conclusions: 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.