J.Jpn. Surg. Soc.. 104(10): 707-710, 2003

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Feature topic

TREATMENT STRATEGY FOR LIVER METASTASIS FROM BREAST CANCER

Distant metastases, including supraclavicular and parasternal lymph node metastases, were observed in about 23% of primary breast cancers in our institute. The liver was the primary site of metastasis in about 8% of cases. This rate was low compared with metastases to the bone, lung, and pleura. As treatment for metastatic lesions to other organs fails, metastatic frequency to the liver increases.
As treatment, whole-body control with chemoendocrine therapy is fundamental. In chemotherapy, anthracyclines are the first choice and taxanes are the second, but the use of herceptin for herceptest-positive patients should be considered. Endocrine therapy should be adopted for patients with hormone receptor-positive tumors. Achieving a temporary partial response is possible, although cure is almost impossible.
The prognosis of patients with metastasis to the liver is poor; the 3- and 5-year survival rates are 22% and 11%, respectively. We must emphasize the prevention of liver metastases by early detection using mass screening with mammography and neoadjuvant/adjuvant chemoendocrine therapy.

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