Breast surgery for metastatic breast cancer

Tosello, Giuliano; Torloni, Maria Regina; Mota, Bruna Salani; Neeman, Teresa; Riera, Rachel

doi:10.1002/14651858.cd011276.pub2

Cited by 68 publications

(61 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…They hold the opinion that various factors including age, comorbidities, tumor type and metastatic disease burden should be considered before opting locoregional treatment in de novo stage IV breast cancer. Moreover, after combination of those two randomized clinical trials, a recent systemic review concluded that existing evidence was insufficient to make definitive conclusions on the survival benefit of breast surgery for patients diagnosed with MBC (14). Recently, clinicians still remain ambivalent about whether to perform primary tumor surgery for patients with MBC.…”

Section: Introductionmentioning

confidence: 99%

Individualized Prediction of Survival Benefit From Locoregional Surgical Treatment for Patients With Metastatic Breast Cancer

Zheng

Zhong

et al. 2020

Front. Oncol.

View full text Add to dashboard Cite

Objective: Recently, performing locoregional surgical treatment still remains debatable in patients with metastatic breast cancer (MBC). Current study aimed to develop prognostic nomograms for predicting the long-term survival in MBC patients with or without surgical intervention, thereby assisting clinicians in making individualized choice.Methods: The training set included 5173 patients who were diagnosed with MBC in 2010-2013 from the Surveillance, Epidemiology, and End Results Program, while the validation set comprised 2924 patients diagnosed in 2014-2015. Multivariant Cox hazard model was applied to determine the independent risk factors for overall survival (OS) and breast cancer specific survival (BCSS). Then, individualized pre-and postoperative nomograms for predicting 1-or 3-year survival probabilities were constructed accordingly. Internal and external validations were conducted to determine the accuracy of these nomograms by calculating concordance index (C-index) and plotting calibration curves.Results: The survival analysis indicated that surgical management conferred improved OS and BCSS in patients with metastatic breast cancer. Age, T stage, grade, distant metastatic site, ER, PR and HER2 status, radiation, and chemotherapy were independent risk factors for OS and BCSS both in surgery and non-surgery group. All these factors were subsequently incorporated into the nomogram which showed acceptable predictive capabilities with C-index range of 0.65-0.80 both in training set and external validation set. In addition, a preoperative nomogram incorporating variables capable of being determined before surgery was also built with C-index above 0.70 both in training and validation set. Conclusion:Surgical management in patients with metastatic breast cancer suggests a potential survival advantage. In addition, these well-validated pre-and postoperative nomograms may provide a useful tool to assist clinicians in treatment decision-making and in evaluating patients' long term prognosis.

show abstract

Section: Introductionmentioning

confidence: 99%

Individualized Prediction of Survival Benefit From Locoregional Surgical Treatment for Patients With Metastatic Breast Cancer

Zheng

Zhong

et al. 2020

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…Secondly, ablation of a progressing lesion has the potential to eliminate the resistant population prior to widespread dissemination. Thus, although evidence for cytoreductive or ablative therapies in the incurable disease setting is lacking in untreated populations [ 13 , 14 ], ablative therapies may have a role in maintaining the efficacy of systemic therapies when the disease burden is low.…”

Section: Introductionmentioning

confidence: 99%

Stereotactic ablative body radiotherapy (SABR) for bone only oligometastatic breast cancer: A prospective clinical trial

et al. 2020

View full text Add to dashboard Cite

Background Stereotactic ablative body radiotherapy (SABR) is an emerging noninvasive approach for the treatment of oligometastases. Limited prospective evidence is available in breast cancer. Objectives To determine the safety and feasibility of single fraction SABR for patients with bone only oligometastatic breast cancer. Secondary endpoints were local and distant progression-free survival (LPFS and DPFS), toxicity and response assessment. Methods and materials In this single institution prospective trial we screened patients with computed tomography, bone scan, and sodium fluoride positron emission tomography. Eligible patients had one to three bone only oligometastases. All patients were treated at a dose of 20Gy in 1 fraction to each metastasis. Kaplan-Meier methods were used to determine local and distant progression free survival (LPFS and DPFS). Toxicity was graded using Common Terminology Criteria for Adverse Event version 4.0. Results 15 eligible patients were recruited to the study. Median follow-up time was 24 months. The treatment was feasible in 12 (80%) of patients with 3 (20%) of patients having treatment delayed by more than 3 days. 10 (67%) of patients experienced grade 1 treatment related toxicity, 4 (27%) experienced grade 2 toxicity and no patients experienced grade 3 or 4 treatment related toxicity. The two-year LPFS was 100%, DPFS was 67%. Conclusion We observed that SABR is feasible, well tolerated and effective in this cohort with two thirds of patients disease-free at two years. In selected patients with bone-only oligometastatic disease, SABR could be considered a treatment option. Randomised trials are required to assess the impact of SABR on overall survival when compared to the standard of care.

show abstract

“…Metastatic breast carcinoma is a relatively common clinical entity with 20–30% of patients with early-stage disease developing metastases and 3–6% with de novo Stage IV disease at time of initial diagnosis [ 1 ]. However, the prognosis of oligometastatic and polygometastatic disease differs considerably pertaining to five-year survival.…”

Section: Introductionmentioning

confidence: 99%

Excision of metastatic breast cancer from sternum and reconstruction in two patients with solitary metastatic spread

Mohamed

Mazhar

Osman

et al. 2020

Journal of Surgical Case Reports

View full text Add to dashboard Cite

Metastatic breast carcinoma is a relatively common clinical entity. However, the prognosis of oligometastatic and polygometastatic disease differs considerably pertaining to five-year survival. Metastatic breast carcinoma to the sternum has been described as early as 1988. We describe two cases in our institution who presented with solitary sternal metastases with a previous history of treated breast cancer. In both cases, there had been a history of previous left breast cancer treated aggressively with surgical resection and adjuvant oncological therapy and maintenance hormonal therapy. Partial sternectomy or total sternectomy for solitary metastatic sternal deposits is well established with relatively low morbidity and mortality and improvement in quality of life and possible improvement in long-term survival. Furthermore, reconstructive options are inherently dependent on extent of resection performed. These techniques can incorporate the use of sternal plates in order to approximate defects and reinforce the sternum in the setting of partial sternectomy.

show abstract

Breast surgery for metastatic breast cancer

Cited by 68 publications

References 46 publications

Individualized Prediction of Survival Benefit From Locoregional Surgical Treatment for Patients With Metastatic Breast Cancer

Individualized Prediction of Survival Benefit From Locoregional Surgical Treatment for Patients With Metastatic Breast Cancer

Stereotactic ablative body radiotherapy (SABR) for bone only oligometastatic breast cancer: A prospective clinical trial

Excision of metastatic breast cancer from sternum and reconstruction in two patients with solitary metastatic spread

Contact Info

Product

Resources

About