The utility of EUS-guided FNA in the diagnosis of metastatic breast cancer to the esophagus and the mediastinum

Jason M. Sobel, Rebecca Lai, Shawn Mallery, Michael J. Levy, Maurits J. Wiersema, Bruce D. Greenwald, Naresh T. Gunaratnam

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Background: Breast cancer can metastasize to the esophagus and the mediastinum. EUS-guided FNA (EUS-FNA) is being used increasingly as a less invasive alternative to mediastinoscopy for procuring a tissue diagnosis of mediastinal disease and may be useful for the diagnosis of breast cancer metastatic to the esophagus and the mediastinum. Methods: Twelve women (age range 54-82 years) with a history of breast cancer presented with dysphagia or other symptoms between 1 and 15 years after initial diagnosis and treatment. CT and endoscopy with biopsies suggested a mediastinal mass or lymphadenopathy with extrinsic esophageal compression but failed to provide a tissue diagnosis. EUS-FNA was performed for diagnosis. Results: Cytologic evaluation of specimens obtained by EUS-FNA confirmed breast cancer metastases in 11 of 12 patients (91%). Recurrent disease was found in intramural masses and periesophageal lymph nodes. No complication resulted from any EUS-FNA procedure. Conclusions: EUS-FNA is safe and effective for the diagnosis of breast cancer metastases to the esophagus and the mediastinum. EUS-FNA may be useful as a first-line method of evaluation when breast cancer metastasis to the esophagus and the mediastinum is suspected.

Original languageEnglish (US)
Pages (from-to)416-420
Number of pages5
JournalGastrointestinal endoscopy
Volume61
Issue number3
DOIs
StatePublished - Mar 1 2005

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