Surgical management of breast cancer liver metastases

HPB (Oxford). 2011 Apr;13(4):272-8. doi: 10.1111/j.1477-2574.2010.00282.x.


Introduction: Selected patients with isolated breast cancer liver metastases (BCLM) may benefit from surgical management; however, indications remain unclear and the risks may outweigh the benefits in patients with a generally poor prognosis.

Methods: Between 1998 and 2006, 17 patients diagnosed with BCLM were considered for surgical management (<4 tumours, tumour <4 cm in diameter and no/stable extrahepatic metastases). Peri-operative and outcomes data were analysed and compared.

Results: Eight patients were found to have extensive or untreatable disease on staging laparoscopy and intra-operative ultrasound (SL/IOUS). The remaining nine patients underwent surgical management [seven laparoscopic radiofrequency ablations (RFA) and two hepatic resections]. Median length of follow-up for patients treated surgically was 40.0 months, median disease-free survival (DFS) was 32.2 months and median time to disease progression was 17.7 months. Of the eight patients not amenable to surgery, median length of follow-up was 21.8 months.

Conclusion: SL/IOUS prevented unnecessary laparotomy in half of the patients taken to the operating room for surgical treatment of BCLM. In patients with BCLM, SL/IOUS should be considered standard of care before surgical intervention. The small number of patients and short follow-up may be inadequate to determine the true value of surgical management in this group of patients with BCLM.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Catheter Ablation / methods*
  • Disease-Free Survival
  • Female
  • Hepatectomy*
  • Humans
  • Laparoscopy*
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Middle Aged
  • Neoplasm Staging
  • Oregon
  • Patient Selection
  • Predictive Value of Tests
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Ultrasonography