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Increasing Pulmonary Infiltrates in a 72-Year-Old Woman With Metastatic Breast CancerPulmonary Infiltrates With Breast Cancer

Melanie C. Bois, MD; Xiaowen Hu, MD; Anja C. Roden, MD; Eunhee S. Yi, MD; Jay H. Ryu, MD, FCCP; Mariam P. Alexander, MD
Author and Funding Information

From the Department of Anatomic Pathology (Drs Bois, Roden, Yi, and Alexander) and the Division of Pulmonary and Critical Care Medicine (Dr Ryu), Mayo Clinic, Rochester, MN; and the Department of Respiratory Disease (Dr Hu), Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China.

CORRESPONDENCE TO: Jay H. Ryu, MD, FCCP, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905; e-mail: ryu.jay@mayo.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(6):e208-e211. doi:10.1378/chest.14-0761
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Extract

A 71-year-old woman, nonsmoker, with a history of metastatic breast cancer was referred for evaluation of worsening pulmonary infiltrates. She described slowly increasing exertional dyspnea and cough in the preceding 3 months. Twenty-two years before, she had been diagnosed with invasive ductal carcinoma of the left breast, for which she underwent a left modified radical mastectomy and prophylactic right simple mastectomy and bilateral breast reconstruction using silicone implants. She subsequently underwent combination chemotherapy. She did well during the following 7 years until an enlarging liver lesion was noted that proved to be metastatic breast cancer, for which she underwent a right hepatectomy. Five years later, she developed intrathoracic and supraclavicular lymphadenopathy, a left pleural effusion, and cervical spine lesions. A biopsy specimen from a supraclavicular lymph node showed metastatic breast cancer, for which she started letrozole therapy with resolution of intrathoracic findings. Twelve months before presentation she underwent bilateral capsulectomy with silicone implant exchange because of pain from implant contracture. Her medications included letrozole, 2.5 mg once a day, and vitamin and Chinese herbal supplements. Her family history was positive for breast cancer in her maternal grandmother.

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