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      18Fluorodeoxyglucose‐positron emission tomography/computed tomography features of suspected solitary pulmonary lesions in breast cancer patients following previous curative treatment

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          Abstract

          Background

          Differentiating pulmonary metastasis from primary lung cancer can be challenging in patients with breast malignancy. This study aimed to characterize the imaging features of 18fluorodeoxyglucose‐positron emission tomography/computed tomography ( 18F‐FDG‐PET/CT) for distinguishing between these diseases.

          Methods

          We enrolled 52 patients who received curative treatment for breast cancer but later presented with suspected solitary pulmonary lesions (SPLs) and subsequently underwent 18F‐FDG‐PET/CT to investigate.

          Results

          Subsolid lesions, ill‐defined borders, lung lesions with negative maximum standardized uptake value, and lesions without 18F‐FDG‐PET/CT‐diagnosed hilar and/or mediastinal lymph nodes and pleural metastases were more likely to be associated with primary lung cancer.

          Conclusions

          CT border, FDG uptake, hilar and/or mediastinal lymph node metastasis, and pleural metastasis are potential markers for diagnosis.

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          Most cited references35

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          Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society.

          Lung nodules are detected very commonly on computed tomographic (CT) scans of the chest, and the ability to detect very small nodules improves with each new generation of CT scanner. In reported studies, up to 51% of smokers aged 50 years or older have pulmonary nodules on CT scans. However, the existing guidelines for follow-up and management of noncalcified nodules detected on nonscreening CT scans were developed before widespread use of multi-detector row CT and still indicate that every indeterminate nodule should be followed with serial CT for a minimum of 2 years. This policy, which requires large numbers of studies to be performed at considerable expense and with substantial radiation exposure for the affected population, has not proved to be beneficial or cost-effective. During the past 5 years, new information regarding prevalence, biologic characteristics, and growth rates of small lung cancers has become available; thus, the authors believe that the time-honored requirement to follow every small indeterminate nodule with serial CT should be revised. In this statement, which has been approved by the Fleischner Society, the pertinent data are reviewed, the authors' conclusions are summarized, and new guidelines are proposed for follow-up and management of small pulmonary nodules detected on CT scans.
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            Long-term follow-up of patients with complete remission following combination chemotherapy for metastatic breast cancer.

            To determine the long-term clinical course of patients with metastatic breast cancer (MBC) who achieved a complete remission with doxorubicin-alkylating agent-containing combination chemotherapy programs. To assess the long-term prognosis of MBC, we reviewed our experience with 1,581 patients treated on consecutive doxorubicin and alkylating agent-containing front-line treatment protocols between 1973 and 1982. Treatment was administered for a maximum duration of 2 years. Characteristics of long-term survivors were evaluated, and hazard rates for progression were calculated. From this group, 263 (16.6%) achieved complete responses (CR) and 49 (3.1%) remained in CR for more than 5 years. After a median duration of 191 months, 26 patients remain in first CR, four patients died in CR at times ranging from 118 to 234 months, 18 patients died of breast cancer, and one is alive with metastatic disease. Compared with the overall CR and total patient populations, the long-term CR group had more premenopausal patients, a younger median age, a lower tumor burden, and better performance status. The hazard function shows a substantial drop in risk of progression after approximately 3 years from initiation of therapy. Ten long-term CR patients developed second primary cancers: breast (3), ovary (2), pancreas (1), endometrium (1), colon (1), head and neck (1), and lung (1). Most patients with MBC treated with systemic therapies have only temporary responses to treatment, but some patients continue in CR following initial treatment. These data show that a small percentage of patients achieve long-term remissions with standard chemotherapy regimens. Remission consolidation strategies are needed.
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              NCCN clinical practice guidelines in oncology: breast cancer screening and diagnosis.

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                Author and article information

                Contributors
                zhulei0519@163.com
                yezhaoxiang@163.com
                wenguixy@163.com
                yuxiaopiyxp@hotmail.com
                Journal
                Thorac Cancer
                Thorac Cancer
                10.1111/(ISSN)1759-7714
                TCA
                Thoracic Cancer
                John Wiley & Sons Australia, Ltd (Melbourne )
                1759-7706
                1759-7714
                21 March 2019
                May 2019
                : 10
                : 5 ( doiID: 10.1111/tca.2019.10.issue-5 )
                : 1086-1095
                Affiliations
                [ 1 ] Department of Molecular Imaging and Nuclear Medicine, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital Tianjin China
                [ 2 ] Department of Radiology, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital Tianjin China
                [ 3 ] Department of Radiology Tianjin 4th Centre Hospital Tianjin China
                [ 4 ] Department of Cardiovascular Surgery Tianjin Medical University General Hospital Tianjin China
                Author notes
                [*] [* ] Correspondence

                Zhaoxiang Ye, Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China; Tianjin's Clinical Research Center for Cancer, Huan‐Hu‐Xi Road, Ti‐Yuan‐Bei, He Xi District, Tianjin 300060, China.

                Tel: +86 22 2334 0123

                Fax: +86 22 2353 7796

                Email: yezhaoxiang@ 123456163.com

                Wengui Xu, Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China; Tianjin's Clinical Research Center for Cancer, Huan‐Hu‐Xi Road, Ti‐Yuan‐Bei, He Xi District, Tianjin 300060, China.

                Tel: +86 22 2334 0123

                Fax: +86 22 2353 7796

                Email: wenguixy@ 123456163.com

                Xiaozhou Yu, Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China; Tianjin's Clinical Research Center for Cancer, Huan‐Hu‐Xi Road, Ti‐Yuan‐Bei, He Xi District, Tianjin 300060, China.

                Tel: +86 22 2334 0123

                Fax: +86 22 2353 7796

                Email: yuxiaopiyxp@ 123456hotmail.com

                [†]

                These authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0003-0213-3619
                Article
                TCA13049
                10.1111/1759-7714.13049
                6500976
                30900387
                c0e93747-24c2-4cb8-be2f-514d5dd2b65e
                © 2019 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 10 February 2019
                : 26 February 2019
                : 01 March 2019
                Page count
                Figures: 2, Tables: 5, Pages: 10, Words: 5946
                Funding
                Funded by: Science & Technology Development Fund of Tianjin Education Commission for Higher Education
                Award ID: 2018KJ057
                Award ID: 2018KJ061
                Funded by: Tianjin Natural Science Fund
                Award ID: 16JCZDJC35200
                Award ID: 17JCYBJC25100
                Funded by: Tianjin Science and Technology Fund
                Award ID: 18PTZWHZ00100
                Award ID: H2018206600
                Funded by: National Natural Science Foundation of China
                Award ID: 81601377
                Award ID: 81501984
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                tca13049
                May 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.2.1 mode:remove_FC converted:06.05.2019

                18fluorodeoxyglucose‐positron emission tomography/computed tomography,breast cancer metastasis,lung cancer,solitary pulmonary lesion

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