The Significance of Prognostic Factors for the Resection of Pulmonary Metastases of Breast Cancer

Abstract

Breast cancer is the most common malignant disease in women in Europe. In 15-25% of cases, the isolated formation of pulmonary metastases occurs. To date these metastases have been treated mainly by chemotherapy, radiotherapy, or hormone therapy. However, good results through pulmonary metastatic resection have been reported increasingly in recent times. From 1979 to 1992, 103 breast-cancer patients underwent surgery for suspected pulmonary metastases in our clinic. Intraoperatively in 88% of the whole group the metastases were confirmed, but in the other 12% they proved to be benign tumors or primary bronchial carcinomas. The operative therapy is standardized in our clinic. The approach is via a median or transverse sternotomy. Wedge resection is the normal procedure, undertaken in 55% of the cases. Complications, which were completely reversible in all cases, occurred in 3%. The 30-day mortality rate was 0%. In the whole patient population, the actuarial 5-year survival was 27%; it was 31% among the completely resected women, whereas no patient undergoing incomplete resection survived 5 years. Taking prognostic criteria into account, there are clear trends. When the disease-free interval exceeded 2 years, the actuarial 5-year survival was 33%, and if the receptor status of the primary tumor was positive, the 3-year survival was 61% compared to 38% for cases with negative receptor status. If a solitary metastasis was removed, the actuarial 5-year survival was 35% as opposed to 0% in cases with more than five metastases.(ABSTRACT TRUNCATED AT 250 WORDS)

Metastatic Disease to the Pancreas and Spleen

“…The 5-year survival has been reported to be as low as 5% to 10%.44-47 Although stage IV breast cancer is generally not a surgical illness, many studies have shown a survival benefit to metastasectomy of solitary lesions, especially those found in the liver and lung. [48][49][50][51][52] Metastasis to the pancreas from breast cancer usually occurs in the setting of diffusely metastatic multiorgan disease. Isolated pancreatic involvement in breast cancer is uncommon, although there are a few published series.…”

Pulmonary metastases of breast carcinomas: Ligandohistochemical, nuclear, and structural analysis of primary and metastatic tumors with emphasis on period of occurrence of metastases and survival

“…Metastatic lesions in the lungs from various tumor types are commonly encountered, and surgical treatment of pulmonary metastases is an important task in adjuvant tumor surgery [1,2]. Although surgical excision of metastases will not be able to definitely cure the patient, survival rates of patients with resected intrapulmonary metastases are encouraging and comparable to those of patients with primary lung carcinoma [1,2].…”

Long-term outcomes and prognostic factors of pulmonary metastasectomy in breast cancer patients: a systematic review

“…[17,18] Pulmonary metastasectomy for metastatic breast cancer was begun more than two decades ago and, since then, few studies were performed which reported significant effects of metastasectomy in improving overall and long-term survival. [16,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] In a recent metaanalysis, the pooled overall five-year survival rate following pulmonary metastasectomy was found to be 46% in patients with breast cancer, while it was 22.5% following systemic treatment in patients with metastatic breast cancer. [34,35] In another study, Yhim et al [30] compared the results of pulmonary metastasectomy in 15 patients with metastatic breast cancer with 30 patients who received systemic treatment alone, and found significantly longer progression-free survival and overall survival in the metastasectomy group.…”