[Is liver resection or radiofrequency ablation indicated in breast carcinoma metastases?]

Until recently, metastasizing of the breast carcinoma to the liver has been considered the sign of the disease process generalization with a poor therapeutic prognosis. Therefore, the aim of this work was to assess any positive effects of liver resections in cases of patients with metastases with respect to the patients' survival rate and the relapse rate of the disorder.

From January 2000 until September 2003, 13 women aged 55.8 years on average (39-71 years of age) underwent surgery in the Surgical clinic of the Faculty Hospital in Plzen for liver metastases of the breast carcinoma. The average period of time from the date of the primary surgery for the breast carcinoma till the breast carcinoma liver metastasis appeared, was 4.3 years (3 months to 9 years). The breast carcinoma liver metastases were solitary in 11 cases and in two cases the metastases were multiple. The authors conducted four right-sided hepatectomies, three segmentectomies, two left-sided lobectomies, three radiofrequence ablations (RFA), one combined surgery--the liver resection and RFA, in total. In seven cases, the histological examination proved a ductal carcinoma and in six cases a lobular carcinoma. Following the surgery, all female patients underwent curative chemotherapy. None of the patients died earlier than 30 days after the surgery. In case of one patient during the complicated hepatectomy, the ductus hepaticus communis was iatrogenically injured, and the situation was solved using hepaticojejunoanastomosis according to Roux. The data were statistically evaluated according to the Kaplan-Meier long-term survival rate and the mestases relapse rate curve. A twelve-month and a thirty-month survival rate were 100%, and 66.7%, respectively. A probability of the relapse anywhere in the body is rated 0% and 71.5%, respectively for the same periods of time following the liver surgery for the breast carcinoma.

Based on the authors' own findings and in conjunction with the current literature data, it is clearly evident that surgical therapy (liver resection, eventually RFA) followed by adjacent chemotherapy is the therapeutic method of choice in cases of patients suffering from the breast carcinoma liver metastases. The above method represents the only chance for a considerable extension of a quality life for women suffering from the breast carcinoma liver metastases.