Recurrent Breast Cancer Initially Mistaken for Organising Pneumonia

This breast cancer diagnosis at a glance

Subtype
Invasive Ductal Carcinoma
Biomarkers
ER-positive and GATA3-positive atypical pleural-fluid cells, suspicious for metastatic breast carcinoma
Sex
Female
Spread to
lungs
Treatment
surgery and hormone therapy
Outcome
Responding Well

Treatment course, step by step

  1. She underwent right mastectomy in 1998 and took tamoxifen for 5 years.
  2. After lung recurrence was confirmed, first-line hormone therapy was started.
  3. Treatment remained ongoing after 12 months of clinical and radiological improvement.

What happened, in summary

A 68-year-old woman developed a persistent dry cough and lost about 6 kg over 6 months. She had been treated for a 3 cm grade 2 invasive ductal cancer of the right breast in 1998. None of 10 lymph nodes contained cancer. She underwent right mastectomy and then took tamoxifen for 5 years.

New lung changes raised concern for recurrence, but a wedge resection showed organising pneumonia and no malignancy. She was treated with prednisolone for presumed cryptogenic organising pneumonia. After 12 weeks, breathlessness worsened, bilateral lung nodules progressed, and a pleural effusion appeared. Pleural fluid contained ER- and GATA3-positive atypical cells suspicious for breast-cancer spread. Repeat bronchoscopy then confirmed malignant cells from metastatic breast cancer.

First-line hormone therapy was started for the recurrence. After 12 months, she had significant clinical and radiological improvement, and treatment was continuing.

Where this story comes from

This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full

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