Effect of Surgery or Radiotherapy of the Breast on Survival in Metastatic Disease: a Retrospective Cohort Study
- 4 Downloads
Evidence to justify survival benefit of local therapy of the breast (LT) for breast cancer patients who are metastatic at presentation (MBC) is weak. The aim of this study is to evaluate the outcome of LT on survival in MBC patients. Patients who had received (1) radiotherapy, (2) surgery, (3) surgery and radiotherapy as LT, and (4) no LT in four groups of 25 were evaluated for 1- and 4-year cause-specific survival (CSS). One- and 4-year CSS in four groups were (1) 76% and 60%, (2) 84% and 56% (3) 80% and 52%, and (4) 48% and 16%, respectively. When controlling for age and site of metastasis as covariates, grouping significantly correlated with survival: F (3, 94): 2.93, P 0.04. Post hoc analysis revealed that the mean survival of group 2: (M 23.39, SE 2.53) was higher than group 4: (M 13.63, SE 2.52, P = 0.03). Surgery as a single modality LT for MBC may provide survival benefit.
KeywordsMetastatic breast cancer Local treatment Radiotherapy Surgery
The authors of this manuscript would like to thank medical registry team and technological personnel of Omid hospital, and all patients and their families for their kind corporation.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- 2.Zeichner SB, Herna S, Mani A, Ambros T, Montero AJ, Mahtani RL, Ahn ER, Vogel CL (2015) Survival of patients with de-novo metastatic breast cancer: analysis of data from a large breast cancer-specific private practice, a university-based cancer center and review of the literature. Breast Cancer Res Treat 153(3):617–624CrossRefGoogle Scholar
- 15.Khan SA, Stewart AK, Morrow M (2003, September) Does local therapy of the intact primary tumor in stage 4 breast cancer affect survival. In: Proc ASCO (Vol 22, p 81)Google Scholar
- 19.King TA, Lyman J, Gonen M, Reyes S, Hwang E-SS, Rugo HS, Liu MC, Boughey JC, Jacobs LK, McGuire KP (2016) A prospective analysis of surgery and survival in stage IV breast cancer (TBCRC 013). In: American Society of Clinical Oncology, vol 34, p 1006Google Scholar
- 20.Soran A, Ozmen V, Ozbas S, Karanlik H, Muslumanoglu M, Igci A, Canturk Z, Utkan Z, Ozaslan C, Evrensel T (2016) A randomized controlled trial evaluating resection of the primary breast tumor in women presenting with de novo stage IV breast cancer: Turkish study (protocol MF07-01). In: American Society of Clinical Oncology, vol 34, p 1005Google Scholar
- 21.Sabel MS, W, J (UpToDate; 2016. www.uptodate.com. Accessed 20 July 2017) The role of local therapies in metastatic breast cancer. Hayes DF, Chagpar AB (ed)
- 22.MO E, ESoMO E pocket guidelines and mobile app: ESMO; 2015 [cited 19/11/2015]Google Scholar
- 23.Network NCC (2018) Breast cancer (version 3.2018). National comprehensive cancer network guidelines. Available at https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Accessed 26 Oct 2018
- 24.Morrow M, Burstein HJ, Harris JR (2015) Malignant tumors of the breast: Chapter 79. In: DeVita VT, Lawre TS, Rosenberg SA (eds) DeVita, Hellman, and Rosenberg’s cancer: principles and practice of oncology, 10th edn. Lippincott Williams & Wilkins, Philadelphia Google Scholar
- 27.Fields RC, Jeffe DB, Trinkaus K, Zhang Q, Arthur C, Aft R, Dietz JR, Eberlein TJ, Gillanders WE, Margenthaler JA (2007) Surgical resection of the primary tumor is associated with increased long-term survival in patients with stage IV breast cancer after controlling for site of metastasis. Ann Surg Oncol 14(12):3345–3351CrossRefGoogle Scholar
- 28.Choi SH, Kim JW, Choi J, Sohn J, Kim SI, Park S, Park HS, Jeong J, Suh CO, Keum KC, Kim YB, Lee IJ (2018) Locoregional treatment of the primary tumor in patients with de novo stage IV breast cancer: a radiation oncologist’s perspective. Clin Breast Cancer 18(2):e167–e178Google Scholar