Improving survival by resection of isolated lung metastases following breast cancer

Objective: Despite multiple modifications in adjuvant of metastatic breast cancer, the survival of women at this stage of disease has not improved thr oughout the last 25 years. Resection of isolated lung metastases as offensi ve surgical therapy has become popular for different kinds of malignancies. Methods: Therefore we retrospectively analysed our patients of the last 20 years who underwent resection of isolated lung metastases following breast cancer. From 96 patients out of a total of 125 patients complete data sets could be obtained. Patients were then retrospectively stratified according surgical strategy: Group It: Complete resection of lung metastases (n 28), Group I: incomplete resection of lung metastases (n=34), Group N: No surgic al treatment for lung metastases (n = 34). Results: No significant differences between these groups were found concern ing stage and histology of the primary tumour, number of metastases and the disease-free interval (DFI). Overall survival of group K (79 months, 80% 5 -year survival, 60% 10-year survival) was significantly better (p < 0.00002 ) compared to group 1 (15.5 months, 0% 5-year survival, 0% 10-year survival ) and group N (9 months, 0% 5-year survival, 0% 10-year survival). Groups I and N did not differ concerning survival. No correlation was found between DFI and survival in group K; however, patients in group N showed a positiv e correlation in this respect (R-2 = 0.81). Conclusion: Our data demonstrate a markedly positive effect on the survival of complete resection of isolated lung metastases after breast cancer. If coin-shaped lesions are seen in the chest x-ray during follow-up of such pa tients, a thoracic surgeon should be contacted. Routine chest x-ray must re main a mandatory element of oncological aftercare following breast cancer.