Metastatic Breast Cancer

 

Metastatic Breast Cancer to the Liver

Liver metastases
Metastatic breast cancer to the liver can be treated with good long-term outcome using minimally invasive robotic liver resection or microwave ablation. A careful patient selection and discussion at a multidisciplinary tumor board/conference are keys for success.

Metastatic breast cancer most often spreads to the bones, lungs, liver, or brain. It is estimated that more than 150,000 women in the United States have metastatic breast cancer. Liver metastases are present in 15 presents of patients newly diagnosed with metastatic breast cancer, and liver is the only site of distant metastasis in 1/3 of these patients. Ultimately, as many as 50% of patients with stage IV breast cancer will developed liver metastasis, which is associated with median survival between 3 and 15 months.

Medical oncologists have historically been very hesitant to refer patients with liver metastasis for consideration of liver resection due to poor reported outcome in earlier series from 1980s. Liver resection in the past was also associated with higher complications due to limited understanding of liver anatomy, poor surgical instrumentation/surgical techniques, and suboptimal postoperative care. With improvement in technology and knowledge over time, liver resection is now part of treatment strategy for selected group of patients, especially for those with liver dominant/only metastasis.

Increasing data on liver resection for metastatic breast cancer have shown improved long-term survival in many patients especially when it is use in conjunction with systemic chemotherapy and hormonal therapy. The median overall survival is as high as 40 months, and a 5 year survival rate is 40 present (with the range of 21-80%).

Dr. Iswanto Sucandy and his team offers minimally invasive robotic liver surgery for selected patients with liver metastasis from breast cancer. The clinical results as well as long-term oncologic outcomes are excellent. Many patients can achieve years of disease-free interval. Combination of improved modern systemic chemotherapy for breast cancer and minimally invasive liver resection is driving the best outcomes. Each patients are discussed at a multidisciplinary tumor board, attended by surgeons, hepatobiliary pathologists, diagnostic radiologists, interventional radiologists, medical oncologists, and radiation oncologists.

It is important to see an experienced liver surgeon or liver specialist in your area to discuss the best treatment strategy for metastatic breast cancer to the liver. Liver biopsy is sometimes necessary for a histological confirmation, prior to starting the cancer treatment. A comprehensive liver cancer program produces the best treatment outcomes.

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