38yr/f.p/w- dry cough ,sob, since 1wk ,h/o left upper limb swelling and erythema without pain since 20days.k/c/0- breast cancer S/p - surgery(mastectomy ,LN -1/30 ,AXILLARY LYMPHADENOPATHY)in 2016 advised for chemo and radiation and taken ,on ayurvedic treatment CXR below please suggest diagnosis and management?? thanx.



A case of breast cancer with left hand swelling ( probably left mastectomy done) and massive pleural effusion left side will be Malignant effusion.Diagnostic and therapeutic tapping to be done.Pleurodesis with sclerosing or chemotherapy drug to be done.Chemotherapy to start if not taken.Other symptomatic treatment to continue

Thanx sir

1. Pleural fluid study 2. ICTD to drain the fluid, f/b pleurodesis 3. Compression bandage of left upper limb and elevation to reduce the lymphedema 4. If malignancy proved: palliative chemotherapy; oncology consultation

Massive pl.effusion left sided c rt lower zone consolidation... Rule out malignancy Do pleural tap ..cytology & biochemistry. CBC , ECHO, CT.

Left sided pleural effusion. Could be malignant effusion due to secondaries in pleural cavity swelling in L upper limb Is lymphoedema.

Left massive pleural effusion with right lower zone infiltrate..in view of history need to rule out malignant effusion..

Left pleural effusion. Do we have pleural fluid reports? Likely malignant pleural effusion.

Left side massive Pleural effusion. Adv diagnostic thorecentesis ? Malignant effusion

It pleural effusion ICD pleurodeisis restage palliative chemo

Left massive pleural effusion likely malignant

Relapse. Only palliative treatment at present

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