Pulmonary resection and systemic lymph node dissection in a patient with breast cancer who had a 33-year disease-free interval

OBJECTIVE Breast cancer metastasis to the lung is common. The resection of lung metastases in patients with breast cancer has been controversial. Here, we present a very rare case of pulmonary and mediastinal lymph node metastases in a patient with breast cancer who had a disease-free interval (DFI) of more than 33 years. METHODS An involved lobectomy and systematic mediastinal lymph node dissection were performed. RESULTS The histological examination confirmed pulmonary metastasis from the breast cancer associated with mediastinal lymph nodes metastasis. CONCLUSIONS To our knowledge, this is the first case reported of a patient with a 33-year DFI after a radical mastectomy for breast cancer who presented with pulmonary metastasis with mediastinal lymph node involvement. This case indicates that a long-term follow-up of breast cancer patients is necessary. Systematic mediastinal lymph node dissection should be considered as a prognostic study during pulmonary metastasectomy for breast cancer.