A case of late recurrence of breast cancer with metachronous bilateral lung metastases

Abstract

We report a case of late recurrence of breast cancer with metachronous oligometastases to the bilateral lungs. A 66-year-old woman was referred to our department due to a slow-growing tumor in the left lung. She underwent breast-conserving surgery and axillary dissection for left breast cancer at the age of 45 and upper lobectomy of the right lung for breast cancer metastasis at the age of 55. Subsequently, the patient developed local recurrence in the left breast at the age of 63. Preoperative chest CT examination for the second breast surgery revealed a small solitary nodule in the upper lobe of the left lung that had grown gradually for three years. With a suspicion of primary lung cancer or pulmonary metastasis, wedge resection under video-assisted thoracoscopic surgery was performed to make a definite diagnosis. The histopathological findings of the resected specimen were consistent with adenocarcinoma that was immunohistochemically positive for ER and negative for TTF-1 and Napsin A. Based on the study, we diagnosed the lung tumor as pulmonary metastasis from breast cancer. Even for metachronous oligometastatic breast cancer with a long disease-free interval, surgery would be feasible if complete resection could be achieved in each stage.