Hydronephrosis Caused by Metastatic Breast Cancer

Area of Science:

• Oncology
• Nephrology
• Urology

Background:

• Breast cancer commonly metastasizes to bone, lung, and liver.
• Metastases to the peritoneum and urinary tract are infrequent but can lead to significant complications.
• Hydronephrosis, characterized by kidney swelling due to urine backup, can result from such rare metastases.

Observation:

• A retrospective review of 1,409 breast cancer surgeries identified 7 cases of hydronephrosis linked to recurrence between 2004 and 2015.
• Patients were a median age of 69, with hydronephrosis diagnosed a median of 47 months post-surgery.
• The majority of cases involved invasive ductal carcinoma and bilateral hydronephrosis, primarily caused by retroperitoneal or lymph node metastasis.

Findings:

• Hydronephrosis in breast cancer recurrence was observed in 7 patients, with median survival of 12 months post-diagnosis.
• Causes included retroperitoneal metastasis (5 cases) and lymph node metastasis (2 cases).
• Treatments varied, including ureteral stents and nephrostomy, with some cases initially untreated.

Implications:

• While rare, hydronephrosis is a serious potential complication of breast cancer recurrence.
• Monitoring for renal dysfunction, infection, and pain is essential in patients with recurrent breast cancer.
• Prompt diagnosis and management of hydronephrosis can mitigate severe renal complications and improve patient care.