Malignant pleural effusion in stage IV breast cancer: an experience from a sub-Saharan Tertiary Hospital

Background : Malignant pleural effusion described as effusion arising from direct infiltration of the pleura by cancer cells, occur in 2-23% of patients with breast cancer during the disease course. Breast cancer accounts for about one third of cases of malignant pleural effusion, second to lung cancer, and is associated with poor quality of life and increased mortality. Methods : This was a retrospective analysis of 85 patients with breast cancer who were referred after detection of pleural effusion with a posteroanterior chest x-ray from the emergency or oncology unit to the cardiothoracic unit of the Lagos University Teaching Hospital between January 2011 and December 2012. Results : A total of 85 patients were studied, with median age of 42 (25-72) years, 39(45.9%) patients were in 35-44 year group. The median disease free interval was 9 months. A high proportion of malignant pleural effusions were ipsilateral (85.9%), and haemorrhagic (61.2%). The 30 day mortality was 45.9%. The major determinants of mortality were the presence of massive haemorrhagic effusion, (OR = 19.2, 95% CI = 3.1- 120.6, p = 0.002), and pulmonary metastatic deposit (OR = 94.7, 95% CI = 9.8-916.72.4, p <0.001). Conclusion : Malignant pleural effusion is a common complication of stage IV breast cancer at our institution, with accompanying high 30 day mortality. Key words : Malignant Pleural effusion, Stage IV Breast cancer, thoracostomy, mortality