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.