Breast cancer complicated by pleural effusion: Patient characteristics and results of surgical management

Abstract

To evaluate the efficiency of pleurodesis (PD) in the management of symptomatic malignant pleural effusion (PE) in breast cancer, we reviewed 46 patients undergoing 49 PDs. When radiotherapy was part of the initial treatment, 41% of PEs were ipsilateral to the primary, if not, 85% of PEs were ipsilateral (P < 0.0075). Six percent of patients presented dyspneic with exertion, 32% during daily routine; 61% at rest. All except 1 were improved after PD; 74% had no dyspnea, 23% had exertional dyspnea. PD relieved chest pain in 4 and cough in 5 patients. With 31 Talc/Iodine PDs, 2 mortalities and 2 minor complications occurred. Of 17 tetracycline PDs, 1 was complicated by bronchopleural fistula and 1 failed. 1 Mustine PD was uncomplicated. Survival at 6, 12, and 24 months was 58%, 40%, and 13%, respectively. Primary local radiotherapy may prevent ipsilateral PE. Talc/Iodine and tetracycline PD reliably provide relief from the distressing symptoms of malignant PE.

Pleurodesis in malignant pleural effusions: Outcome and predictors of success

“…The statistical distribution of malignant effusions among the different cancers in this study resembles that in the literature. Lung carcinoma followed by breast carcinoma is the leading cause of malignant effusions [10][11][12]. In this study, lung adenocarcinoma was the most prevalent histology among patient who underwent pleurodesis for malignant pleural effusion (in 30.6% of patients) followed by infiltrating ductal carcinoma of the breast (in 17.7%).…”

Impact of pleural effusion pH on the efficacy of thoracoscopic mechanical pleurodesis in patients with breast carcinoma

“…In breast carcinoma, pleural fluid accumulation is most often caused by the obstruction of pleural lymphatic drainage [2] or direct tumour infiltration of pleural space [11]. According to various authors, 35 -50% of recurrent MPE in patients with breast carcinoma can be treated by systemic therapy [11,12], while the rest require local palliative interventions to prevent fluid accumulation and thus improve the patients' quality of remaining life.…”

Symptom Management in Metastatic Breast Cancer

“…Malignant pleural effusions are also a common cause of dyspnea in breast cancer patients, occurring in ϳ10% of breast cancer patients [72]. Pleurodesis with doxycycline or talc may be indicated for symptom relief, as well as serial thoracenteses or even the placement of a PleurX catheter for palliative management in patients who are not suitable for pleurodesis [73,74].…”