Long-term survival after hepatectomy for large metastatic breast cancer: a case report

Long-term survival after the resection for liver metastasis from breast cancer is rare. We report on a 49-year-old woman who has been alive and well for 12 years following hepatic resection for metastatic breast cancer. Fourteen years before, the patient underwent a radical mastectomy for cancer of the right breast. One year after the operation the patient presented with right upper quadrant pain and a large isolated right lobe liver metastasis was found. Initially, it was too large to be treated by hepatectomy. Thus, intra-arterial one-shot injection of 20 mg of mitomycin C mixed with 4 mL of lipiodol was given three times at 1-month intervals and was followed by 5-fluorouracil (250 mg) and mitomycin C (2 mg) administered 9 times at 2-week intervals through the implanted port. Additionally, 150 mg of 5-fluorouracil and 1200 mg of medroxiprogesterone acetate were orally administered for 5 months. These therapies led to a remarkable reduction in tumor size and the metastasis was safely resected by an extended right hepatic lobectomy. The specimen was completely necrotic and histologically no viable tumor cell was observed. In the present case, the aggressive preoperative chemo- and hormonal therapies might be significant in making a contribution to longer survival.