2013, Number 5
<< Back Next >>
Med Int Mex 2013; 29 (5)
Breast Cancer and Pericardial Effusion
Cortés-Ramírez JM, Ramirez-Rodríguez M, Cortes TJMJ, Cortes TRA, de la Torre-Murillo R, Salazar SA, Carrillo-Aguilar SI, Reyes-Méndez BJ, Jiménez-Legaspi E, López-Martínez FR, Torres-Hernández JA, Villalobos-Pérez CF
Language: Spanish
References: 16
Page: 541-544
PDF size: 165.73 Kb.
ABSTRACT
Breast cancer is a common disease and recurrences are common and/or distant affection, 10% have metastatic disease, of which 10% will cause heart disease, such as malignant pericardial effusion may cause cardiac tamponade (CT) acute or subacute and requires rapid diagnosis and treatment. Confirmation through pericardiocentesis occurs in up to 92%. The CT data are presented with low cardiac output and venous congestion, the presentation is extremely serious, the treatment can lead to a good functional status, with survival rates of 10 to 13 months, although one of the main problems is recurrence. Definitive diagnosis is given by the echocardiogram and CT angiography. The ideal treatment to prevent recurrence with less morbidity and hospitalization, is successful if the patient survives, symptoms do not recur and do not require new interventions, without regard to the time the patient survives. Management depends on whether or not important hemodynamic data and if there are not, is conservative. If there are, depends on the long term prognosis of neoplasia: pericardiocentesis, pericardial window or pericardiectomy. We present two cases, one patient required pericardial window and another not.
REFERENCES
Lanza LA, Natarajan G, Roth JA, et al. Long-term survival after resection of pulmonary metastases from carcinoma of the breast. Ann Thorac Surg 1992;54:244-248.
Heinman R, Ferguson D, Powers C, et al. Angiogenesis as a predictor of long term survival for patients with node negative breast cancer. J Natl Cancer Inst 1996;88:1764- 1769.
Nicolson Gl. Organ specificity of tumor metastases: role of preferential adhesion, invasion and growth of malignant cells at specific secondary sites. Cancer Metastasis Rev 1988;7:143-88.
Van Geel An, Pastorino U, Jauch KW. Surgical treatment of lung metastases. Cancer 1996;77;657-682.
Kamby C, Vejborg I, Kristesen B, et al. Metastatic pattern in recurrent breast cancer. Cancer 1988;62:2226-2233.
Redding WH, Coombes RC, Monaghan P. Detection of micrometastases in patients with primary breast cancer. Lancet 1983;2:1271-1274.
Hassler GB. Thoracic surgical problems in breast cancer therapy. In: Hassler. Cancer of the breast. Philadelphia: Saunders Company, 1995.
Johnson KA, Kramer BS, Crane JM. Management of pleural metastases in breast cancer. En: Bland KI, Copeland ED editores. The breast. 2ª ed. Philadelphia: Saunders, 1998;121.
Shan SA. Malignant pleural effusions. Clin Chest Med 1985;6: 113-125.
Bischiniotis TS, Lafaras C T, Platogiannis DN, Moldovan L, Barbetakis NG, Katseas GP. Intrapericardial cisplatin administration after pericardiocentesis in patients with lung adenocarcinoma and malignant cardiac tamponade. Hellenic J Cardiol 2005;46:324-329.
Levin BH, Aaron B. The subxyphoid pericardical window. Surg Gynecol Obstet 1982;155:804-806.
Gregory JR, McMurtrey MJ, Mountain CF. A surgical approach to the treatment of pericardical effusions in cancer patients. Am J Clin Oncol 1985;8:319-323.
Graeber GM. Complications of therapy of malignant tumors involving the pericardium. In: Roth JA, editor. Thoracic Oncology. Philadelphia: Saunders, 1989.
Vaitkus P T, Herrmann HC, LeWinter MM. Treatment of malignant pericardial effusion. JAMA 1994;272:59-64.
Cormican MC, Nyman CR. Intrapericardical bleomycin for the management of cardiac tamponade secondary to malignant pericardical effusion. Br Heart J 1990;63:61-62.
Cacavale RJ. Video assisted thoracic surgery for pericardical disease. Chest Surg Clin North Am 1993;3:271-281.