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Case Report Open Access

Metastatic breast cancer in primary lung cancer with compound EGFR mutations: A case report

  • Authors:
    • Tianyao Yang
    • Yifan Xu
    • Xi Lin
    • Guodong Chen
    • Fangfang Wang
  • View Affiliations / Copyright

    Affiliations: Department of Breast Surgery, The People's Hospital of Tiantai County, Taizhou, Zhejiang 317200, P.R. China, School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325035, P.R. China
    Copyright: © Yang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 128
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    Published online on: February 9, 2026
       https://doi.org/10.3892/ol.2026.15481
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Abstract

The epidermal growth factor receptor (EGFR) is the most common driver gene in the development and progression of non‑small cell lung cancer (NSCLC). Mutations in EGFR exons 18‑21 are frequently observed, particularly exon 19 deletions and the exon 21 L858R point mutations. The T790M mutation in EGFR exon 20 was the first resistance mechanism to tyrosine kinase inhibitors (TKIs) identified in EGFR‑mutant NSCLC. The coexistence of an exon 19 deletion and the exon 20 T790M missense mutation in EGFR is relatively rare, with a low incidence. The incidence of breast metastasis from primary lung cancer ranges from 0.5 to 6.0%, making it an infrequent occurrence. The present study reported a patient with primary NSCLC harboring both an EGFR exon 19 deletion and the exon 20 T790M missense mutations, who developed metastatic breast cancer after being progression‑free for 1 month. Following the Chinese Society of Clinical Oncology and National Comprehensive Cancer Network guidelines for lung cancer, the patient was treated with furmonertinib, a third‑generation targeted antitumor therapy. The present case provides notable insights for the diagnosis and treatment of NSCLC with coexisting EGFR exon 19 deletion and exon 20 T790M missense mutation, and a rare clinical example of breast metastasis from lung cancer.
View Figures

Figure 1

Imaging examination results of the
disease course. (A) Baseline CT (August 2023): Mass shadow at hilum
of lung, atelectasis of lower lobe of right lung, moderate effusion
in right chest cavity. (B) After 8 months CT (April 2024): The mass
shadow near the hilum of the right lung, the focus was markedly
smaller compared with that at baseline. The multiple small nodules
in the right lung were smaller compared with that at baseline and
the inflammation of both lungs was basically absorbed. The right
pleural thickening, pleural effusion, markedly improved compared
with that at baseline. (C) CT at 1 year later (August 2024):
Atelectasis is progressing and there is a lot of effusion in the
right chest. The right lung is not fully inflated and the right
lung is newly inflamed.

Figure 2

Cancer cells were identified in the
smear of pleural effusion alveolar and lavage fluid, which tends to
lung adenocarcinoma. (A) Low (magnification, ×40), (B) medium
(magnification, ×100) and (C) high (magnification, ×400).

Figure 3

Color Doppler ultrasound results. (A)
June 2024 Breast color Doppler ultrasound: Hypoechoic area of right
breast, with unclear boundary and irregular shape. (B) August 2024
Breast color Doppler ultrasound: Blurred edge, irregular shape,
blood flow signals around.

Figure 4

Immunohistochemical results: Positive
for CK7, Ki-67 (~60%+), Napsin A and TTF-1 and negative for ER, PR,
CK5/6, Sox10, GATA3, mammaglobin and HER2 (magnification, ×200).
ER, estrogen receptor; PR, progesterone receptor; GATA3, GATA
binding protein 3; TTF-1, thyroid transcription factor 1.
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Copy and paste a formatted citation
Spandidos Publications style
Yang T, Xu Y, Lin X, Chen G and Wang F: Metastatic breast cancer in primary lung cancer with compound <em>EGFR</em> mutations: A case report. Oncol Lett 31: 128, 2026.
APA
Yang, T., Xu, Y., Lin, X., Chen, G., & Wang, F. (2026). Metastatic breast cancer in primary lung cancer with compound <em>EGFR</em> mutations: A case report. Oncology Letters, 31, 128. https://doi.org/10.3892/ol.2026.15481
MLA
Yang, T., Xu, Y., Lin, X., Chen, G., Wang, F."Metastatic breast cancer in primary lung cancer with compound <em>EGFR</em> mutations: A case report". Oncology Letters 31.4 (2026): 128.
Chicago
Yang, T., Xu, Y., Lin, X., Chen, G., Wang, F."Metastatic breast cancer in primary lung cancer with compound <em>EGFR</em> mutations: A case report". Oncology Letters 31, no. 4 (2026): 128. https://doi.org/10.3892/ol.2026.15481
Copy and paste a formatted citation
x
Spandidos Publications style
Yang T, Xu Y, Lin X, Chen G and Wang F: Metastatic breast cancer in primary lung cancer with compound <em>EGFR</em> mutations: A case report. Oncol Lett 31: 128, 2026.
APA
Yang, T., Xu, Y., Lin, X., Chen, G., & Wang, F. (2026). Metastatic breast cancer in primary lung cancer with compound <em>EGFR</em> mutations: A case report. Oncology Letters, 31, 128. https://doi.org/10.3892/ol.2026.15481
MLA
Yang, T., Xu, Y., Lin, X., Chen, G., Wang, F."Metastatic breast cancer in primary lung cancer with compound <em>EGFR</em> mutations: A case report". Oncology Letters 31.4 (2026): 128.
Chicago
Yang, T., Xu, Y., Lin, X., Chen, G., Wang, F."Metastatic breast cancer in primary lung cancer with compound <em>EGFR</em> mutations: A case report". Oncology Letters 31, no. 4 (2026): 128. https://doi.org/10.3892/ol.2026.15481
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