title: Liver resection and local ablation of breast cancer liver metastases--a systematic review.
abstract: OBJECTIVE
  To analyze surgical treatment of breast cancer liver metastases (BCLM) regarding selection criteria, outcome and prognostic parameters.
  
  
  METHODS
  We searched Embase and Medline for all studies published 1999-2010.
  
  
  RESULTS
  Resection was associated with a median survival (MOS) of 20-67 months and 5-year survival of 21-61%. Local ablation also had a favorable outcome; MOS was 30-60 months and 5-year survival 27-41%. Regarding selection, no specific limits regarding the number and size of BCLM can be given. Features of the primary breast cancer (BC) were not significant for the prognosis. Microscopically radical (R0) resection is a positive prognostic factor, while the effects of disease interval, hormone receptor status and response to preoperative chemotherapy were divergent. The presence of EHD had a negative effect on survival in some studies, but failed to have so in other studies.
  
  
  CONCLUSIONS
  Surgical therapy may benefit a subset of patients with BCLM. Resection may be indicated, if an RO-resection can be done with a low risk of mortality. Liver resection in the presence of extrahepatic disease remains controversial, while patients with BCLM and bone metastases could possibly be managed differently than other EHD.
authors: Department of Surgical Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark. m.bergenfeldt@telia.com
authors: M
authors: M
authors: Bergenfeldt
authors: B V
authors: BV
authors: Jensen
authors: B
authors: B
authors: Skjoldbye
authors: D
authors: D
authors: Nielsen