Curative liver resection for metastatic breast cancer

Aims: Hepatic resection is a standard procedure in the treatment of colorec tal liver metastases. Liver metastases are frequent in breast cancer, but r esectional treatment is rarely possible and few reports have addressed the results of surgical treatment for metastatic breast cancer. The aim of our study was to analyse the outcome of patients with metastatic breast cancer after resection of isolated hepatic secondaries and possibly to identify se lection criteria for patients who may benefit from surgery. Methods: Between 1984 and 1998. 90 patients with a history of breast cancer and suspected liver metastases were referred for surgical evaluation. Fift y-four patients also had extrahepatic disease or metastases from another pr imary tumour; multiple liver metastases were not amenable to surgical treat ment in 20 patients. Five patients were treated by regional chemotherapy vi a an intra-arterial port catheter; after liver resection two patients were found to have liver metastases from intercurrent colorectal cancer. Thus on ly nine liver resections for metastatic breast cancer could be performed wi th curative intent. Results: No patient died post-operatively after liver resection. In the fol low-up period, four of the nine patients who were treated with curative int ent received systemic chemotherapy. At a median follow-up of 29 months, fou r patients died from tumour recurrence. Five patients are currently alive. Five-year survival in the resection group was calculated as 51% (Kaplan-Mei er estimate). Node-negative primary breast cancer and a long interval betwe en treatment of the primary and liver metastases appeared to be associated with long survival after liver resection. Conclusions: These observations suggest that careful follow-up and adequate patient selection could offer some patients with isolated liver metastases from breast cancer a chance of long-term survival.