The role of surgery for pulmonary metastases in breast cancer patients

[摘要] In breast cancer, oligometastatic disease is a controversial concept. Generally, solitary pulmonary lesions are detected on chest imaging made for other reasons (unintentionally). The majority of these pulmonary lesions in breast cancer patients prove to be unrelated (bronchogenic carcinoma or benign lesions), 33–40% are in fact breast cancer metastases. Only a small number of breast cancer patients (0.4–1%) will have potentially resectable isolated metastasis to the lung.Controlled studies comparing pulmonary metastasectomy to systemic therapy or best medical care are lacking. Overall survival (OS) data in patients who underwent metastasectomy are favourable despite the high incidence of recurrences. Long-term survival is seen primarily in patients with only one or two lesions and long initial disease-free interval. Radical resections with unnecessary loss of pulmonary parenchyma should be avoided, since there is no benefit of such resection in terms of survival and the incidence of complications is higher.Foremost justification of surgical resection for lung lesions in breast cancer patients is differentiation of metastatic breast cancer from new primary lung cancer. The survival impact of pulmonary resection in ‘oligometastatic’ breast cancer is probably limited and attempts should be made to limit the amount of tissue removed.

[学科分类] 肿瘤学