Liver resection for breast cancer metastases

BACKGROUND/AIMS: The prognosis of patients with hepatic metastases (HM) fro m breast cancer receiving no treatment is extremely poor. Results of system ic and regional chemotherapy as well as other treatment modalities, such as immunotherapy or hormonal therapy, are disappointing in this group of pati ents, with median survival rates hardly exceeding 1 year. METHODOLOGY: We performed a retrospective analysis of patients undergoing r esection of isolated HM from breast cancer to determine the morbidity, mort ality and prognosis following this procedure. RESULTS: Fifteen female patients underwent liver resection between Septembe r 1985 and April 1997. Two patients had synchronous and 13 patients had met achronous HM. The mean number of HM was 3.3 (1-9) (bilobar in 6 patients) w ith a mean diameter of 5.3cm (2-11cm). The following resections were perfor med: wedge resection (4), left lateral segmentectomy (2), right hemihepatec tomy (3), left hemihepatectomy (I), extended right hemihepatectomy (3) and extended left hemihepatectomy (2). There was no hospital mortality. Morbidi ty (transient hepatic failure (n=2) and intra-operative hemorrhage necessit ating splenectomy (n=1)) occurred in 3 patients. Median follow-up was 12 (1 -88) months. Six patients developed recurrent liver disease; 2 relapsed els ewhere. Six of these 8 patients died. Overall median survival following liv er resection was 57 months with 1-, 2- and 3-year survival rates of 100%, 7 1.4% and 53.6% respectively. CONCLUSIONS: Liver resection is a viable treatment option for selected pati ents with isolated HM from breast cancer that can be performed safely. It s hould be considered in individual patients if the operative risk is low, if no extrahepatic disease is present and provided a complete resection with clear margins is technically feasible.