Patients with liver metastasis from breast cancer have a poor prognosis, although this may be improved by hepatectomy in a selected group with disease confined to the liver. We evaluate the effectiveness of thermonecrosis by overheated steam (TOS) as a cytoreductive strategy in the management of liver metastasis from primary breast cancer. METHODS Prospective study from 2004 untill 2008 when four patients with hepatic metastasis from primary breast cancer underwent TOS (micropulses of steam) provided directly via microtube inserted into the tumor by open and laparoscopic approach. RESULTS The median age of the patients was 53 years (range, 46–61 years), 2 had disease confined to the liver, with 2 having stable extrahepatic disease in addition. Two patients are alive and disease-free, median follow-up after TOS was 27.5 months (range, 15–45 months). TOS was not associated with any mortality or major morbidity. CONCLUSIONS Control of hepatic metastasis from breast cancer is possible using TOS and may lead to a survival benefit, particularly in those patients with disease confined to the liver.