Liver metastases from breast cancer: the role of surgical treatment.
OBJECTIVE
To evaluate short- and long-term outcomes in the surgical treatment of liver metastases from breast cancer


METHODS
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.
d'Annibale
M
M
III Division of Surgical Oncology, Regina Elena Cancer Institute, Rome, Italy.
Piovanello
P
P
Cerasoli
V
V
Campioni
N
N
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods / Q000401:mortality*; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome