EBUS-TBNA for the diagnosis of intrathoracic lymphadenopathy in patients with previously diagnosed breast carcinoma

Abstract

The diagnostic method of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) for the confirmation of extrathoracic malignant disease dissemination into mediastinal lymph nodes has been proven as highly efficient (sensitivity 93%, specificity 100%). The aim of this research was to carry out a retrospective study of the medical records of patients with newly developed mediastinal/hilar lymphadenopathy (ML) and previously diagnosed extrathoracic malignant disease, select the patients with previously diagnosed breast carcinoma, and analyze the results of EBUS-TBNA. The retrospective, single-center clinical observational study was conducted in the period from January 2015 to August 2017, in which the EBUS-TBNA results were analyzed for 77 patients who had met the inclusion criteria. A malignant etiology of the ML was confirmed in 39/77 patients (50.64%). Patients with previously diagnosed breast carcinoma showed a divergence within this group. A malignant etiology of the ML was confirmed in 10/14 patients (71.42%), and a benign one in 3/14 patients (21.42%). In one patient with reactive lymphadenopathy and pulmonary parenchymal infiltration, primary lung carcinoma was confirmed by thoracotomy. Two patients showed signs of reactive/granulomatous ML during chemotherapy with paclitaxel, and in one patient sarcoidosi was confirmed. To conclude, in spite of the high percentage of a malignant etiology of newly developed ML in patients with previously diagnosed breast carcinoma, their cytological verification is necessary due to the possibility of a reactive/granulomatous lymph node reaction, especially in patients undergoing chemotherapy with paclitaxel.