Benefits of Surgical Treatment of Stage IV Breast Cancer for Patients With Known Hormone Receptor and HER2 Status

Stahl, Kelly A.; Wong, William G.; Dodge, Daleela; Brooks, Ashton J.; McLaughlin, Christopher; Olecki, Elizabeth J.; Lewcun, Joseph A.; Newport, Kristina; Vasekar, Monali; Shen, Chan

doi:10.1245/s10434-020-09244-5

Cited by 26 publications

(17 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This deficit in the literature is significant as de novo MBC patients account for approximately 6 % of all breast cancer patients in the United States [ 10 ]. Additionally, although systemic therapy is the main treatment modality among MBC patients, approximately 25 % of MBC patients undergo surgery [ [11] , [12] , [13] ]. Informed by the inconsistent evidence of the benefits of surgery, current National Comprehensive Cancer Center (NCCN) guidelines discourage routine surgical resection in de novo stage IV breast cancer patients but indicate surgery can be considered for local control or in the setting of a response to systemic treatment [ [14] , [15] , [16] ].…”

Section: Introductionmentioning

confidence: 99%

Low neighborhood socioeconomic status is associated with higher mortality and increased surgery utilization among metastatic breast cancer patients

Bhattacharyya

Tsung

et al. 2021

The Breast

View full text Add to dashboard Cite

Purpose Low socioeconomic status (SES) is associated with advanced stage, lower-quality care, and higher mortality among breast cancer patients. The purpose of this study is to examine the association between neighborhood SES (nSES), surgical management, and disease-specific mortality in de novo metastatic breast cancer (MBC) patients in the Surveillance, Epidemiology, and End Results (SEER) Program. Methods MBC patients ages 18 to 85+ years diagnosed from 2010 through 2016 were identified in SEER. The cohort was divided into low, middle, and high nSES based on the NCI census tract-level index. Univariable and multivariable analyses were used to examine the relationship between nSES, surgery, and disease specific mortality in MBC patients. Results There were 24,532 de novo MBC patients who met study criteria, with 28.7 % undergoing surgery. Over the study period, surgery utilization decreased across all nSES groups. However, lower nSES was associated with a higher odds of undergoing surgery (low OR 1.25 [1.15–1.36] p < 0.001; middle OR 1.09 [1.01–1.18] p = 0.022; ref high). Living in an area with lower SES was associated with a worse disease specific mortality (low HR 1.24 [1.25, 1.44; ], middle 1.20 [1.1–1.29]: ref high). Specifically, there was a 9.26 month mean survival differences between the lowest (41.02 ± 0.47 months) and highest (50.28 ± 0.47 months) nSES groups. Conclusion These results suggest area of residence may contribute to differences in surgical management and clinical outcomes among de novo MBC patients. Future studies should examine the contributions of patient characteristics and preferences within the context of surgeon recommendations.

show abstract

Section: Introductionmentioning

confidence: 99%

Low neighborhood socioeconomic status is associated with higher mortality and increased surgery utilization among metastatic breast cancer patients

Bhattacharyya

Tsung

et al. 2021

The Breast

View full text Add to dashboard Cite

show abstract

“…Our study used the National Cancer Database to investigate patients with stage IV breast cancer and known hormone receptor and HER2 status who had undergone systemic therapy (ST) with or without surgical intervention, excluding patients who died within the first 6 months of diagnosis. 2 We found that the addition of surgical intervention was associated with better survival, regardless of biologic subtype; further neoadjuvant timing of ST in ER ?, PR ? or HER2 ?…”

Section: Presentmentioning

confidence: 76%

ASO Author Reflections: Surgery Offers Survival Advantage in Treatment-Responsive Metastatic Breast Cancer

2020

Self Cite

View full text Add to dashboard Cite

“…Limited data is available in regards to surgical intervention in stage IV patients about luminal subtypes and sequence of therapy. Like Stahl K et al [22] we also favor giving systemic therapy first and then offering surgery. Our results show significant benefit not only in high-risk Luminal B Her 2 positive but also in the triple-negative group, which was evident in years 2 and 5.…”

Section: Discussionmentioning

confidence: 88%

Impact of Surgery in De Novo Metastatic Breast Cancer after Systemic Disease Control

Soomro

Khokher

Zahid

2021

JAMMR

View full text Add to dashboard Cite

Background: Systemic chemotherapy is the standard of care for patients with metastatic breast cancer, with an undecided role in surgery. Limited data is available for the role of surgery on the overall survival of stage 4 breast cancer regarding luminal subtypes of patients. This is a retrospective data analysis comparing overall survival benefit and disease-free survival in stage IV breast cancer after systemic treatment and systemic disease control concerning luminal classification in the last five years. Method: Patients who had surgery and no surgery after systemic treatment and disease control were compared for 5 years overall survival as the primary endpoint and disease-free survival as the secondary endpoint. The survival benefit was also compared regarding tumor biology (ER/PR, HER2 status). Results: Data included 421 patients, 237 in surgery and 184 in no surgery group. At one year survival for surgery performed and not performed was not significant. Five-year overall survival for surgery performed and not performed was 84.4% and 74.5%. A statistically significant difference in survival rates was observed (p<0.0001). The mortality rate was 15.6% in surgery performed and 25.5% in the no-surgery group which showed a significant difference among the two study groups (p=0.011). We found statistically significant differences in luminal B (p=0.004) and triple-negative breast cancer patients (p=0.001) for survival rates in surgery performed and not performed groups. Disease-free survival has shown no significant difference in surgery performed and not performed group in 1, 2, and 5 years follow-up. Conclusion: Surgery has a positive impact on overall survival in Stage 4 patients with systemic disease control even in high-risk luminal B, Her 2 Positive, and triple-negative breast cancer patients. There was no significant difference observed in disease-free survival who were operated on or not. However, there was no local recurrence in the operated group.

show abstract

Benefits of Surgical Treatment of Stage IV Breast Cancer for Patients With Known Hormone Receptor and HER2 Status

Cited by 26 publications

References 29 publications

Low neighborhood socioeconomic status is associated with higher mortality and increased surgery utilization among metastatic breast cancer patients

Low neighborhood socioeconomic status is associated with higher mortality and increased surgery utilization among metastatic breast cancer patients

ASO Author Reflections: Surgery Offers Survival Advantage in Treatment-Responsive Metastatic Breast Cancer

Impact of Surgery in De Novo Metastatic Breast Cancer after Systemic Disease Control

Contact Info

Product

Resources

About