Yoshimoto Masataka, Tada Keiichiro, Nishimura Seiichiro, Makita Masujiro, Iwase Takuji, Kasumi Fujio, Okumura Sakae, Sato Yukitoshi, Nakagawa Ken
Breast Oncology Group, Cancer Institute Ariake Hospital, Ariake 3-10-6, Koto-ku, Tokyo 135-8550, Japan.
Breast Cancer Res Treat. 2008 Aug;110(3):485-91. doi: 10.1007/s10549-007-9747-9. Epub 2007 Sep 27.
We retrospectively evaluated whether a surgical strategy benefits patients with operable lung metastasis of breast cancer. Between 1960 and 2000, 90 patients (mean age 55.1; range 32-77) with lung metastasis (79 solitary, 11 multiple) underwent surgery as follows: wedge resection (n = 10), segmental resection (n = 11), lobectomy (n = 68) and pneumonectomy (n = 1). The metastases were completely resected in 89% of them. One patient died due to surgical complications. The overall 5- and 10-year cumulative overall survival rates were 54% and 40%, respectively (median, 6.3 years). Fifteen patients survived without relapse for over 10 years. They were 24% of those who progressed for 10 years or more after lung surgery. The most significant prognostic factor was disease-free interval (DFI) and stage at breast surgery. The 10-year survival rates of those with >==3 and <3 years of DFI were 47% and 26%, respectively (P = 0.014). Survival times were significantly longer for patients with clinical stage I at breast surgery than those with stage II-IV (P = 0.013). Our data, although limited and highly selective, suggest that surgical approach to lung metastasis from breast cancer may prolong survival in certain subgroups of patients to a greater extent than systemic chemotherapy alone. Surgical approach to lung metastasis of breast cancer, if possible, should be a treatment of choice to a great extent.
