Liver metastases from breast cancer: the role of surgical treatment

Hepatogastroenterology. 2005 Nov-Dec;52(66):1858-62.

Abstract

Background/aims: To evaluate short- and long-term outcomes in the surgical treatment of liver metastases from breast cancer

Methodology: Between 1984 and 1999 we observed 26 patients with secondary liver localization (25 metachronous) from breast cancer. The median disease-free interval was 70 months (4-136). Median age at the time of liver surgery was 56 years (36-76). The 18 patients included: 1 patient at stage 1, 10 at IIA, 6 stage II B and 1 patient at stage IV. Seven patients were found to have axillary lymph nodes metastases. Fifteen patients had infiltrating ductal carcinoma, 2 a lobular carcinoma and 1 patient a mixed-component carcinoma. The grading was G3 in 10 and G2 in 8 patients. Regarding the recettorial status, 5 patients were ER+ PR-, 8 patients were ER+PR-, 4 patients were ER-PR-. In 9 cases the patients underwent adjuvant chemotherapy (5 of them following postoperative radiotherapy) and in 14 cases Tamoxifen was used. Surgery was conservative in 13 cases and demolitive in 5 cases.

Results: The follow-up (3-70 months) was completed in 15 patients out of 18 observed cases. Nine patients died; six patients are still living, 4 of them "disease-free", 2 having advanced metastatic disease, in treatment. There was neither long-term or perioperative major morbidity nor mortality in our group. The overall 5-year-survival was 25% in patients whose liver metastases developed within 3 years after breast surgery compared with 40% in those ones with metastatic disease diagnosed more than 3 years after.

Conclusions: Surgery of liver metastases from breast cancer can be performed with low morbidity and mortality in selected patients.

MeSH terms

  • Adult
  • Aged
  • Biopsy, Needle
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / therapy
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Hepatectomy / methods
  • Hepatectomy / mortality*
  • Humans
  • Immunohistochemistry
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery*
  • Middle Aged
  • Neoplasm Staging
  • Palliative Care
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Time Factors
  • Treatment Outcome