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Malignant pleural effusion — SCE Respiratory MCQ

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ModeratePleural DiseaseMalignant pleural effusionSCE Respiratory

A 78-year-old woman with metastatic breast cancer has recurrent symptomatic left pleural effusion. The lung re-expands fully after therapeutic aspiration and pleural fluid cytology confirms malignancy. She wants to minimise hospital visits and has expected survival of several months. What is the most appropriate management?

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Correct answer: D — Indwelling pleural catheter or talc pleurodesis after shared decision-making

For symptomatic malignant pleural effusion with expandable lung, definitive intervention with an indwelling pleural catheter or talc pleurodesis should be discussed according to patient priorities. Repeated aspiration may be suitable for very limited prognosis but is burdensome over months. Diuretics do not treat malignant pleural fluid production.

Reference: BTS Pleural Disease Guideline 2023