Pulmonary Resection for Metastatic Breast Cancer

Abstract

Thirty-three patients treated primarily with surgical excision of pulmonary metastases from breast cancer were compared with 30 patients treated primarily with systemic chemohormonal therapy. Treatment for patients in the surgical group included pulmonary resection alone in 20, resection plus adjuvant systemic therapy in nine, and resection plus adjuvant radiation therapy in four. Treatment for patients in the medical group included systemic therapy alone in 22 and systemic therapy plus local radiation therapy in eight. Mean survival in the surgical group was significantly longer than that in the medical group, even when only those patients who manifested single pulmonary nodules were compared (58 months vs 34 months). The overall 5-year survival rate after treatment of lung metastasis was significantly greater for the surgical group than for the medical group (36% vs 11%). The results of this study indicate that surgical resection should be considered in patients with breast cancer who develop operable pulmonary metastases without evidence for concomitant extrapulmonary disease. In selected patients, such therapy may result in a survival benefit.

Ressecção cirúrgica de metástases pulmonares: estudo prospectivo em 182 pacientes

“…Todos os estudos publicados enfocam a importância prognóstica da abordagem cirúrgica das lesões metastáticas pulmonares, com impacto evidente nas taxas de sobrevida a longo prazo, além da necessidade de ressecção completa de todos os nódulos pulmonares para beneficiar os pacientes com metástases pulmonares 16,[36][37][38][39][40][41][42][43] . A ressecabilidade correlaciona-se com melhor sobrevida pós-toracotomia.…”

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.…”

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.…”

“…[12] Similar to other malignancies such as colorectal cancer, pulmonary metastasectomy was used for the treatment of metastasis from primary breast cancer with favorable effects in improving five-year survival. [13,14] As of 2000 to date, the rate of pulmonary metastasectomy has dramatically increased among common cancer types, as well as breast cancer. [15] In this systematic review, we aimed to evaluate long-term outcomes and prognostic factors of pulmonary metastasectomy in breast cancer patients in the light of literature data.…”