Tremendous gains have been made regarding the treatment of breast cancer. The combination of chemotherapy, radiation therapy, and surgery have vastly improved patient course. Hepatic manifestations of metastatic breast cancer are extremely difficult to treat. Traditionally, chemotherapy and hormonal treatment of hepatic metastases of breast carcinoma have not significantly improved survival. For patients with breast cancer metastases isolated to the liver, operative treatment is increasingly being used to prolong life and disease-free intervals. This article reviews the use of surgery for treatment of isolated breast cancer metastases to the liver.