Breast cancer and liver metastases: an imaging perspective on the potential of resectability

Background Liver metastases occur in approximately 50% of patients with metastatic breast cancer (MBC). Currently, few patients with breast cancer liver metastases (BCLM) are considered for surgical intervention. Purpose To estimate the proportion of BCLM patients potentially eligible for targeted liver intervention. Material and Methods A total of 17,035 women were included (1991–1996) in the prospective Malmö Diet and Cancer Study. Diagnostic liver imaging (performed in 2003–2018) of women within the cohort later diagnosed with breast cancer (BC) was evaluated according to a predefined protocol. A multidisciplinary conference assessed BCLM resectability based on liver imaging and overall metastatic burden. Patients with non-skeletal, extrahepatic BC metastases were considered unresectable. Fisher's exact test and Kruskal–Wallis test were used for statistical comparisons. Results Among 1242 women initially diagnosed with BC, 249 were further diagnosed with MBC of which 57 had liver metastases; of these, 48 had available and assessable images. Based on liver imaging and the overall metastatic burden, 10 (21%) patients had liver metastasis that were considered resectable. No statistically significant differences were found between resectable and unresectable groups in age at primary BC diagnosis, age at BCLM diagnosis, mode of BC detection, or primary BC tumor parameters. Conclusion Approximately one-fifth of BCLM patients in this cohort could potentially have been eligible for targeted intervention of liver metastases. These findings contribute to the limited evidence on BCLM resectability and may inform future treatment strategies.