Abstract
A 70-year-old woman visited our hospital complaining of worsening dysphagia. She underwent left mastectomy for left breast cancer (Stage IIb) 10 years previously and was given oral anastrozole as adjuvant hormonal therapy for 7 years after completion of adjuvant chemotherapy. She had been on retreatment by hormonal therapy for left supraclaviclar lymph node recurrence detected 9 years postoperatively. Upper gastrointestinal endoscopy revealed stenosis encircling the entire circumference of the middle thoracic esophagus without mucosal change and the endoscope could not pass through beyond this point. No malignant findings were detected in the biopsy tissue and treatments with balloon dilatation catheter and stent placement were difficult. As positron emission tomography (PET) examination showed limited bone and lymph node metastases, video-assisted thoracoscopic subtotal esophagectomy (VATS-E) was carried out with intent to make the precise diagnosis and to ameliorate dysphagia. The pathological diagnosis was esophageal metastasis of breast cancer. Minor anastomotic leakage occurred but healed with conservative management. She was discharged on day 30 after the operation. Over the following eight months, her oral intake gradually recovered and she is treated with chemotherapy. Chemotherapy is generally chosen for treatment of esophageal metastasis from breast cancer, but VATS-E is a potential option for achieving symptomatic amelioration.
