cqvip:Background: Breast cancer can metastasize to the esophagus and the mediastinum . EUS-guided FNA (EUS-FNA) is being used increasingly as a less invasive alter native to mediastinoscopy for procuring a tissue diagnosis of mediastinal diseas e and may be useful for the diagnosis of breast cancer metastatic to the esophagus and the mediastinum. Methods: Twelve women(age range 54-82 years) with a history of breast cancer presented with dy sphagia or other symptoms between 1 and 15 years after initial diagnosis and tre atment. CT and endoscopy with biopsies suggested a mediastinal mass or lymphaden opathy with extrinsic esophageal compression but failed to provide a tissue diag nosis. EUS-FNA was performed for diagnosis.Results: Cytologic evaluation of spe cimens obtained by EUSFNA confirmed breast cancer metastases in 11 of 12 patient s(91%). Recurrent disease was found in intramural masses and periesophageal lym ph nodes. No complication resulted from any EUS-FNA procedure. Conclusions: EUS -FNA is safe and effective for the diagnosis of breast cancer metastases to the esophagus and the mediastinum. EUS-FNA may be useful as a first-line method o f evaluation when breast cancer metastasis to the esophagus and the mediastinum is suspected.
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