Surgical Management Of Patients With Metastatic Breast Cancer

Adam I. Riker1, SuHu Liu1, Mona Hagmaier1, Matthew J. D'Alessio1, and Charles E. Cox2

1University of South Alabama-Mitchell Cancer Institute, 301 North University Blvd., MSB 2015, Mobile, AL 36688, USA; 2 University of South Florida, Mofitt Cancer Center, 13902 Magnolia Drive, Tampa, FL 33612, USA Mitchell Cancer Institute, University of South Alabama, Mobile, AL, USA

Abstract: Metastatic breast cancer can be a difficult problem to manage surgically as the sole mode of treatment. In certain cases, surgical management is the initial treatment of choice, such as sentinel lymph node mapping and nodal dissections for locoregional control. Other situations, such as metastatic breast cancer to solid organs, such as the brain, liver, and lung, are dictated by individual patient characteristics and the overall clinical situation. Clearly, surgery has become a part of the broader management schema in treating patients with metastatic breast cancer, with developing technologies, such as stereotactic radiosurgery, greatly enhancing our ability to treat such patients. Surgery is a single, but important, tool that should be combined with other modes of therapy, such as hormonal therapy and radiation therapy, to optimize treatment strategies and patient outcomes. There remains a fair amount of controversy as to the clinical significance of micrometastatic disease within the lymph nodes and bone marrow, a relevant topic that is actively being examined by clinicians and researchers from around the world. Regardless, the role of surgery for patients with metastatic breast cancer has become a central part of the multidisciplinary care of such patients, with this review providing an overview of the various aspects of surgical management of metastatic disease.

Keywords: metastastic breast cancer, micrometastatic, sentinel lymph node, surgical management, locoregional recurrence, bone metastasis, lung metastasis, liver metastasis

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