Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-22T20:42:28.605Z Has data issue: false hasContentIssue false
  • English
  • Français

Natural progression and clinical significance of incidentally detected pulmonary nodules in radiotherapy planning CT scans of breast cancer patients: a retrospective cohort

Published online by Cambridge University Press:  09 September 2016

Sasidharan Balu Krishna ,
Sunitha Susan Varghese ,
Paul Gopu Gopurathingal ,
Venkata Krishna Reddy Pilaka  and
Selvamani Backianathan
Sasidharan Balu Krishna*
Affiliation:
Christian Medical College Vellore, Vellore, Tamil Nadu, India
Sunitha Susan Varghese
Affiliation:
Christian Medical College Vellore, Vellore, Tamil Nadu, India
Paul Gopu Gopurathingal
Affiliation:
Christian Medical College Vellore, Vellore, Tamil Nadu, India
Venkata Krishna Reddy Pilaka
Affiliation:
Christian Medical College Vellore, Vellore, Tamil Nadu, India
Selvamani Backianathan
Affiliation:
Christian Medical College Vellore, Vellore, Tamil Nadu, India
*
Correspondence to: Sasidharan Balu Krishna, Christian Medical College Vellore, Vellore, Tamil Nadu, India. Tel: 00 91 9626262296. Fax: 91 4162282035. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim

Indeterminate pulmonary nodules incidentally detected during radiological imaging completed for radiotherapy planning always creates dilemma for the oncologist. The purpose of this study is to evaluate the clinical significance of pulmonary nodules incidentally detected in patients undergoing locoregional radiotherapy for breast cancer and present a retrospective analysis of the natural progression of such nodules.

Methods

A retrospective review of computed tomography scans of breast cancer patients who underwent radiotherapy over a period of 3 years to screen out patients with indeterminate lung nodules was undertaken. This was correlated with the patient and tumour characteristics and the status of the disease at last follow-up.

Results

Of the 132 patients reviewed 28 had indeterminate lung nodules. Of the 28 patients, four had progressive lung nodules on follow-up. Subgroup analyses did not show any significant correlation.

Discussion and conclusion

One fifth of patients may present with incidentally detected lung nodules. Multiple nodules, ER negative status and locally advanced breast cancer may point to a higher risk of these nodules progressing to metastatic cancer. There is no indication to stop locoregional therapy in the presence of indeterminate nodules, but close follow-up of high-risk group is recommended.

Keywords

breast cancer clinical dilemmacomputed tomographyincidental findingspulmonary nodules
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 15 , Issue 4 , December 2016 , pp. 359 - 363
Check for updates
Copyright
© Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Ferlay, J, Shin, H-R, Bray, F, Forman, D, Mathers, C, Parkin, D M. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010; 127 (12): 2893–2917.CrossRefGoogle ScholarPubMed
2. Gonzalez-Angulo, A M, Morales-Vasquez, F, Hortobagyi, G N. Overview of resistance to systemic therapy in patients with breast cancer. Adv Exp Med Biol 2007; 608: 1–22.Google Scholar
3. Meimarakis, G, Rüttinger, D, Stemmler, J et al. Prolonged overall survival after pulmonary metastasectomy in patients with breast cancer. Ann Thorac Surg 2013; 95 (4): 1170–1180.Google Scholar
4. Naidich, D P, Bankier, A A, MacMahon, H et al. Recommendations for the management of subsolid pulmonary nodules detected at CT: a statement from the Fleischner society. Radiology 2013; 266 (1): 304–317.Google Scholar
5. Gould, M K, Donington, J, Lynch, W R et al. Evaluation of individuals with pulmonary nodules: when is it lung cancer? Chest 2013; 143 (5 suppl): e93S–e120S.CrossRefGoogle ScholarPubMed
6. Lee, B, Lim, A, Lalvani, A et al. The clinical significance of radiologically detected silent pulmonary nodules in early breast cancer. Ann Oncol 2008; 19 (12): 2001–2006.CrossRefGoogle ScholarPubMed
7.TB Statistics for India – National and state statistics [Internet]. TB Facts.org. http://www.tbfacts.org/tb-statistics-india/. Accessed on January 10th 2016.Google Scholar
8. Quint, L E, Park, C H, Iannettoni, M D. Solitary pulmonary nodules in patients with extrapulmonary neoplasms. Radiology 2000; 217 (1): 257–261.Google Scholar
9. Daglar, G, Yuksek, Y N, Gozalan, U, Tutuncu, T, Kama, N A. The significance of pulmonary nodule in breast cancer patients. Bratisl Lekárske Listy 2010; 111 (5): 280–283.Google Scholar