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Regression Of Pulmonary Metastases Of A Breast Cancer

Dao, T. L. 1962Breast cancer

DAO T. L. (1962). Regression of pulmonary metastases of a breast cancer. report of a case of spontaneous and temporary regression after radical mastectomy. Archives of surgery (Chicago, Ill. : 1960), 84, 574–577. https://doi.org/10.1001/archsurg.1962.01300230090017

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Abstract

Clinical observations suggestive of host defense against cancer are numerous. Among them, the most intriguing phenomenon is the "spontaneous regression" of metastatic disease after removal of the primary tumor. Spontaneous disappearance of a pulmonary metastasis of a carcinoma of the kidney following nephrectomy has been reported by several authors.<sup>1-3</sup>It is also known that pulmonary metastases of chorio-carcinoma may disappear after removal of the primary tumor.<sup>4</sup> There has been no report in the literature of spontaneous regression of pulmonary metastases of a breast cancer after radical mastectomy. The case reported here also illustrates some interesting features of the clinical behavior of a hormone-dependent mammary cancer. <h3>Report of Case</h3> The patient was first seen at the Roswell Park Memorial Institute on Oct. 10, 1956, at the age of 65. She was referred here for the diagnosis and treatment of a mass in the right breast and axilla, a mass

Case Details

Disease Location

Right breast with metastases to axilla, lymph nodes and lungs

Personal Characteristics

65-year-old female

Clinical Characteristics

Referred for diagnosis and treatment of a mass in the right breast and axilla. A mass that had been noticed 2 months before admission. Physical examination: firm nodular mass in the right breast at about 12 o'clock, with retraction of the nipple. Posterior to the anterior axillary fold, there was a 2 cm mass, firm, nontender, and fixed to the skin. In the left breast at bout 1 o'clock there was a 2 c firm mass also with skin retraction. Diagnostic impression was one of bilateral carcinema of the breast with metastasis to the right axilla. Preoperative x-ray showed a large nodular density in the right lower lung field. A right radical mastectomy was performed first, and after an interval of 10 days, a left radical mastectomy. Histological ex¬ amination of the right breast revealed duct car¬ cinema with métastases to 13 of the 18 axillary lymph nodes removed, and that of the left breast a moderately well-differentiated carcinema. 4 months later, the nodule disappeared. 2 years after surgery, the nodular lesion on the right lung became visible again. Next year another lesion of similar characteristics was found in the left lung. That same year, adrenalectomy was performed.

Remission Characteristics

2 months after the operation, the lesion in the right lower lung field showed a marked diminution in size. Four months after the operation, the mass completely disappeared. Three months after adrenalectomy, both nodular lesions disappeared.

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Double mastectomy bilateral adrenalectomy