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Case Reports
. 2024 Dec 23;18(1):635.
doi: 10.1186/s13256-024-05001-4.

Liver resection for breast cancer-related liver metastases: a case report

Eko Adhi Pangarsa  1 , Erik Prabowo  2 , Subiyakto  3 , Wasisto Dwi Yudisaputro  3 , Hermawan Istiadi  4 , Jessica Novia Hadiyanto  5 , Kevin Tandarto  5 , Daniel Rizky  6 , Budi Setiawan  6 , Damai Santosa  6 , Catharina Suharti  6
Affiliations
Case Reports

Liver resection for breast cancer-related liver metastases: a case report

Eko Adhi Pangarsa et al. J Med Case Rep. .

Abstract

Introduction: Breast cancer liver metastasis presents a significant challenge in clinical oncology, with limited treatment options and poor prognosis. This case series study explores the extended survival achieved in breast cancer patients with liver metastases through a combination of surgical and medical interventions.

Case presentation: We present three cases of Javanese female patients with breast cancer (51 years old, 42 years old, and 55 years old) with liver metastases who underwent hepatic resection followed by systemic therapy. The cases illustrate successful outcomes with disease-free survival ranging from 5 to 31 months post-surgery. Key prognostic factors associated with improved survival include prolonged interval between initial diagnosis and detection of liver metastasis, liver-limited disease, positive response to preoperative systemic therapy, and expression of estrogen and progesterone receptors in the metastatic lesions.

Conclusion: These findings underscore the potential efficacy of a multidisciplinary approach integrating local hepatectomy with systemic therapy in selected patients with breast cancer liver metastasis. Further research is warranted to identify optimal patient selection criteria and refine treatment strategies for improved outcomes.

Keywords: Breast cancer; Hepatic resection; Liver metastasis; Multidisciplinary approach; Prognostic factors; Systemic therapy.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The Ethics Committee of Dr. Kariadi General Hospital has approved this study. All participants provided written informed consent after receiving a comprehensive explanation of the study’s objectives, benefits, and risks. Consent for publication: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests: None.

Figures

Fig. 1
Fig. 1
Magnetic resonance imaging of abdomen with contrast. Before hepatectomy, there were five rim-enhanced nodules in segments 6, 7, and 8 of the liver, suggesting metastasis. Following hepatectomy, no nodules are observed in the liver, spleen, or pancreas
Fig. 2
Fig. 2
Anatomy pathology. The liver tissue sections show swollen, hyperemic hepatocyte lobules, among which malignant cells with round oval nuclei, pleomorphic, hyperchromatic, coarse chromatin, prominent nucleoli, eosinophilic cytoplasm, and mitosis can be found, arranged to form glandular structures (A). Immunohistochemical examination of excised liver lobe (× 10 magnification). Positive expression of hepatocyte GATA-3 (B) and mammoglobin (C) in tumor cells
Fig. 3
Fig. 3
Anatomy pathology. The preparation from the liver consists of liver cells containing 2–3 cells per plate, in the swollen hepatic parenchyma, hyperemic. Among these, there is infiltration of malignant epithelial cells arranged to form glandular structures approximately 95 percent, the rest are solid. These cells have round to oval nuclei, are pleomorphic, hyperchromatic, with chromatin coarse to vesicular, prominent nucleoli, eosinophilic and vacuolated cytoplasm. Lymphovascular invasion is observed. A 100× magnification; B 400× magnification
Fig. 4
Fig. 4
Magnetic resonance imaging of abdomen with contrast. Before hepatectomy, a solitary iso-hypodense lesion with clear boundaries and regular edges is visible in segment 7 of the liver (size ± 4.6 × 3.7 cm) attached to the right hepatic vein, showing inhomogeneous enhancement after contrast administration. Following hepatectomy, no solid mass is visible in the liver
Fig. 5
Fig. 5
Computed tomography scan showed multiple nodules in the liver parenchyma, with sizes of 10.4 mm in segment III and 13.2 × 21.3 mm in segment IVa, accompanied by ascites and multiple mesenteric lymph nodes, suggesting a metastatic process. Splenomegaly was also observed
See this image and copyright information in PMC

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