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Video‐assisted management of malignant pleural effusion in breast carcinoma
Author(s) -
Gasparri Roberto,
Leo Francesco,
Veronesi Giulia,
DePas Tommaso,
Colleoni Marco,
Maisonneuve Patrick,
Pelosi Giuseppe,
Galimberti Viviana,
Spaggiari Lorenzo
Publication year - 2005
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21623
Subject(s) - medicine , malignant pleural effusion , pleurodesis , pleural effusion , breast carcinoma , surgery , carcinoma , pleural disease , effusion , respiratory disease , breast cancer , lung , cancer
BACKGROUND Advanced breast carcinoma almost always leads to a malignant pleural effusion, conditioning the performance status of patients and consequently quality of life. The treatment of malignant pleural effusion should be a priority in the management of such patients. The results of videothoracoscopic approach (VATS) chemical pleurodesis was analyzed in patients with recurrent pleural effusion from breast carcinoma. METHODS From October 1998 to June 2004, 71 consecutive patients with breast carcinoma‐related pleural effusion were treated by the same thoracic‐surgeon team with intracavitary nebulization of 8 g of asbestos‐free sterilized talc via VATS. Multiple pleural biopsies were performed to determine biologic characteristics of recurrent disease. RESULTS Talc pleurodesis was performed in all cases, with no intraoperative or postoperative complications. Median length of hospital stay was 5 days (range, 5–8). The overall success rate of the surgical procedure was 89% (confidence interval [CI], 79–95%) with a mean follow‐up of 22 months (range, 2–81 mos). The overall survival time was 17 months (range, 2–80). Biopsies showed a switch on receptor status and c‐erB‐2 status from negative (primary tumor) to positive (pleural metastasis) in 11 (15%) patients. In another 7 (9.8%) patients, we obtained completely new information that was hitherto unknown. CONCLUSION Talc pleurodesis via VATS is an effective and safe procedure that yields a high rate of success at the first attempt and achieves long‐term control of malignant pleural effusion due to breast carcinoma. Concomitant biopsies performed during the VATS procedure were a determining factor in the subsequent decision‐making process. Cancer 2006. © 2005 American Cancer Society.