PULMONARY RESECTION FOR METASTATIC BREAST-CANCER

Between 1982 and 1992, 60 consecutive female patients underwent pulmon ary resection for metastatic breast carcinoma. Median age was 58 years (range, 21 to 81 years). The median tumor-free interval after primary breast cancer operation was 2.2 years (range, 7 days to 20.6 years). Thirty-one patients (51.6%) had solitary pulmonary metastases. Forty p atients (66.7%) had complete pulmonary resection, which consisted of w edge excision in 33, lobectomy in 6, and pneumonectomy in 1. The remai ning 20 patients had incomplete resection, which consisted of wedge ex cision in all. Altogether, 8 patients (13.3%) had development of posto perative complications, which included pneumothorax, prolonged air lea k, pulmonary embolism, retained secretions requiring bronchoscopy, atr ial fibrillation, and chest tube site infection, There was one operati ve death (1.7%). Follow-up was complete in all patients and ranged fro m 23 days to 10.7 years (median, 3.5 years). Recurrence developed in 3 2 of the 39 survivors (82.1%) who had complete resection. Median disea se-free interval after lung resection was 1.6 years (range, 23 days to 9.3 years). Overall 5-year survival was 37.8% (95% confidence interva l, 25.1% to 50.5%). The 40 patients who had complete resection had a 5 -year survival of 35.6% (95% confidence interval, 20.4% to 50.8%) as c ompared with 42.1% (95% confidence interval, 19.0% to 65.3%) for the 2 0 patients with incomplete resection (p = not significant). Although p ulmonary resection is safe, we could not demonstrate improved survival after complete pulmonary resection of metastatic breast carcinoma in this highly selected group of patients.