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Postgraduate Education Corner: PULMONARY AND CRITICAL CARE PEARLS |

Multiple Pulmonary Nodules in a 70-Year-Old Female With a History of Breast Cancer

Sharon Lynn Gambino, DO; Christopher S. King, MD; Christopher J. Lettieri, MD, FCCP
Author and Funding Information

Affiliations: From the Departments of Internal Medicine (Dr. Gambino), and Pulmonary and Critical Care Medicine (Drs. King and Lettieri), Walter Reed Army Medical Center, Washington, DC.

Correspondence to: Sharon Lynn Gambino, DO, Walter Reed Army Medical Center, Internal Medicine, 6900 Georgia Ave NW, Washington, DC 20307; e-mail: sharon.gambino@amedd.army.mil


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(3):938-941. doi:10.1378/chest.08-2994
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Extract

A 70-year-old woman was referred to the pulmonary clinic for the evaluation of multiple pulmonary nodules that had been noted on a routine surveillance CT scan performed after a diagnosis of breast cancer. On presentation to the pulmonary clinic, she denied symptoms, including dyspnea, hemoptysis, weight loss, fevers, chills, or night sweats. She did report a dry, nonproductive cough of several months duration. The patient's medical history was significant for stage 1 (T1bN0M0) infiltrating breast carcinoma that had been diagnosed approximately 1 year prior to the current presentation. Treatment had consisted of a lumpectomy, and negative surgical margins were achieved. The patient declined radiation therapy and was given therapy with anastrazole. The patient also reported a history of hypertension, hyperlipidemia, peripheral vascular disease, and collagenous colitis. Prior surgeries included the recent lumpectomy, an appendectomy, carotid endarterectomy, and a total abdominal hysterectomy. Her medications included mesalamine, simvastatin, lisinopril, atenolol, clopidogrel, and anastrazole. The patient had no notable travel history. She had a 15-pack-year smoking history, but had quit 13 years prior.

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