Effect of Primary Tumor Extirpation in Breast Cancer Patients Who Present With Stage IV Disease and an Intact Primary Tumor

Abstract

Removal of the intact primary tumor for breast cancer patients with synchronous stage IV disease is associated with improvement in metastatic progression-free survival. Prospective studies are needed to validate these findings.

Impact of breast surgery on survival in patients with distant metastases at initial presentation: a systematic review of the literature

“…Some studies reported that the use of chemotherapy was lower among women who underwent surgery [9]. In contrast, other studies found that these women were more likely to receive chemotherapy, hormonal therapy, or both than patients who did not have surgery [8,13]. In one study patients, who received surgery were significant older than patients who were not treated with surgery [12].…”

“…In most studies, the patients who had surgery were significantly younger when compared to the patients who did not had surgery [7-10, 12, 13]. These patients had also smaller primary tumors and more often just one metastatic localization [8,9,12,13]. Some studies reported that patients who had surgery also had less extensive regional disease [8,15].…”

“…These patients had also smaller primary tumors and more often just one metastatic localization [8,9,12,13]. Some studies reported that patients who had surgery also had less extensive regional disease [8,15]. The patients who received surgery were also less likely to have concomitant diseases [13].…”

“…Therefore, local treatment of the primary tumor is only recommended if the primary tumor is symptomatic. However, recent studies suggest that breast surgery has a favorable impact on the prognosis of patients with primary metastatic breast cancer, and that it may be time to reconsider the treatment paradigm ''no surgery of the primary tumor'' [7][8][9][10][11][12][13]. On the other hand, not all studies addressing this subject have reported a better prognosis for the patients undergoing surgery [14][15][16], and the investigators of these studies suggest that the beneficial effect seen in other studies may be the result of selection bias.…”

Improved survival of patients with primary distant metastatic breast cancer in the period of 1995–2008. A nationwide population-based study in the Netherlands

“…In this study, which was based In the current study, we analyzed the changes in prognosis for more than 8,000 patients with primary distant metastatic breast cancer diagnosed between 1995 and 2008 and followed until 2010, using nation-wide data of the Netherlands Cancer Registry. As described above, surgery of the primary tumor is not standard treatment in these patients, though several retrospective studies have shown an improvement in overall survival in patients who have received breast surgery [5][6][7][8][9][10][11]. Therefore, we also analyzed the impact of surgical resection of the primary breast tumor, besides the role of systemic treatment.…”