Patterns of lung metastasis on chest computed tomography scan studies in breast cancer patients and associated factors at St. Paul’s hospital millennium medical college Addis Ababa, Ethiopia.

Abstract

ABSTRACT Background: In Ethiopia, breast cancer is the most diagnosed cancer and the leading cause of cancer death in women. Computed tomography is often the preferred modality for monitoring metastatic disease due to its ability to determine the extent of local and metastatic disease. Lung metastasis represents a significant challenge in the management of breast cancer, affecting treatment decisions and prognosis. Objective: To asses patterns of lung metastasis on chest CT scan studies in breast cancer patients and associated factors at St. Paul’s hospital millennium medical college. Methods: A facility based retrospective patients record review study was conducted by analyzing chest CT scan images of all patients who are diagnosed with Breast cancer with biopsy and lung metastasis with chest CT at St. Paul’s Millennium Medical College (SPHMMC) in September 1, 2023- May 30, 2024. A template was prepared to collect data from the respective patient clinical records (charts as well as electronic medical recording/EMR) by the principal investigator and one trained radiology resident. Their CT findings was accessed from the radiology information system (RIS); Histopathology result was collected from EMR/chart or from pathology department, then data was entered into Epi info data version 4.6 and exported into SPSS version 26 for analysis. The presence of a statistically significant difference in the characteristics of the dependent and independent variables was assessed using the chi-square test, with a p-value of less than 0.05 indicating statistical significance. Results: Out of the 165 patients studied, 164 (99.4%) were females and only 1 (0.6%) was male. 142 (86.2%) of the patients initially presented with stage IV disease. A higher proportion of patients accounting about 154 (93.3 %) had invasive ductal subtype beast carcinoma and 8 (4.8 %) had invasive ductal carcinoma. The majority of breast tumor subtypes were characterized by negative receptor status with the triple negative (ER, PR and HER 2 negative) status accounting for about 85 (51.5%). The most common lung metastasis pattern was multiple pulmonary noodles which was noted in 116 patients and the least common was endobrochial metastasis spread which was seen in only 2 (1.2 %) of the studied patients. No significant association was found with the age demographic of the patients as well as histologic and molecular subtypes of breast cancer with the patterns of breast cancer metastasis. Conclusion: The common age group of the patients in our study with advanced breast cancer and lung metastasis were relatively younger. Most of the participants are pre-menoupausal and peri-menoupausal. The commonest CT patterns for lung metastasis were multiple nodules. There was no statistically significant relationship between the histologic and molecular tumor characteristics and the likelihood of specific pattern of lung metastasis.