Thoracic metastases from breast cancer: A single-institution's experience

Objective: Thoracic metastasis from breast cancer (TMBC) is a relatively uncommon condition, and few reports of its therapeutic palliation and patient outcomes exist. We therefore reviewed retrospectively our radiotherapeutic experience of TMBC. Methods: Between 1981 and 2003, 19 patients were treated with radiation (with doses raging from 10 Gy to 50 Gy) for palliation of TMBC. Results: The mean age was 55.4 years. Mediastinal lymph node disease was the most common form of TMBC. TMBC developed within five years of breast cancer diagnoses in 11 patients (58%). Among the evaluable symptomatic individuals, subjective palliation was complete in 78% of the cases. The complete objective response (e.g., complete resolution of clinically manifested superior vena caval obstruction or imaging-demonstrated atelectasis) rate was 50%. There was no significant difference in survival between patients presenting with airway obstruction and women who were not in respiratory distress, asymptomatic and symptomatic patients, and women with and without concurrent extrathoracic metastases. Conclusion: Although the prognosis of women with TMBC was quite ominous, radiotherapy should be considered in very symptomatic patients because justifiable palliation can be effected in some individuals.