Practical consensus recommendations regarding role of mastectomy in metastatic breast cancer

Somsekhar, SP; Geeta, Kekre; Jain, Rahul; Nayyer, R.; Halder, Shikha; Malik, Vinod; Parikh, Purvish M.; Aggarwal, Sandeep; Koul, Rakesh

doi:10.4103/sajc.sajc_106_18

Cited by 7 publications

(7 citation statements)

References 20 publications

(21 reference statements)

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“…This is because half of our patients were diagnosed at advanced stages or progressed during the neoadjuvant chemotherapy. Hence, although there are recommendations of case by case evaluation for the surgical approach, if the disease is at stage IV or do not respond to chemotherapy, the main objective would be improving the quality of life and the survival benefit of tumor removal is still inconclusive [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Triple-negative breast cancer in Peru: 2000 patients and 15 years of experience

et al. 2020

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Background Epidemiological studies commonly identify the clinical characteristics and survival outcomes of patients with breast cancer at five years. Our study aims to describe the sociodemographic, clinicopathological characteristics and determine the long-term event-free survival (EFS) and overall survival (OS) of a Peruvian population with triple-negative breast cancer. Methods We reviewed the medical records of new cases treated at a single institution in the period 2000-2014. The survival analysis included patients with stages I-IV. Survival estimates at 10 years were calculated with the Kaplan-Meier method and compared with the Log-rank test. We further used multivariate Cox regression analysis to calculate prognostic factors of recurrence and mortality. Results Among the 2007 patients included, the median age at diagnosis was 49 years (19-95 years). Most patients presented histologic grade III (68.7%), tumor stage II (34.2%), and III (51.0%) at diagnosis. Local and distant relapse was present in 31.9 and 51.4% of the patients, respectively. The most frequent sites of metastasis were the lungs (14.5%), followed by bone (9.7%), brain (9.6%), and liver (7.9%). The median follow-up was 153 months. At 3, 5, and 10 years, the EFS of the population was 55%, 49%, and 41%, respectively, while the OS was 64%, 56%, and 47%, respectively. Moreover, an N3 lymph node status was the most important prognostic factor for both disease relapse (HR: 2.54, 95% CI:

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Section: Discussionmentioning

confidence: 99%

Triple-negative breast cancer in Peru: 2000 patients and 15 years of experience

et al. 2020

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“…It was reported in 6 studies that progression-free survival is better on those who underwent surgery (Hazard Ratio from 0.66 to 0.361). Primary tumor resection also corresponded to longer median overall survival, up to 16 months higher when compared to women who did not undergo surgical resection [1][2][3], [6][7], [11]. The latest randomized study published, the MF07-01 trial, included 274 patients randomized in two groups: systemic therapy (ST) alone and loco-regional surgery (LRS) after ST.…”

Section: Resultsmentioning

confidence: 99%

“…The resection of primary tumor is one of them and is highly debatable nowadays, as, until recently, it has been seen as palliation and not expected to have impact on survival. Although there are some polemic opinions about the surgical treatment, some of the latest researches have emphasized that once the primary tumor is resected women with advanced breast cancer have better prognosis, with reasonably low risks concerning morbidity and mortality after the procedure [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“…Retrospectives studies had shown that a specific group of patients could benefit from primary tumor resection (PTR) including younger age and those presenting oligometastatic disease. Considering possible biases that can happen in these studies, recent prospective ones have tried to investigate whether primary tumor resection can improve survival or not [1][2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…In this regard, most recent evidences have suggested that women who undergo surgery to extirpate the primary tumour have improved survival [1][2][3], [6][7][8][9][10][11]. Primary tumor resection in this stage has shown positive impact due to multifactorial causes as increased chemotherapeutic efficacy, preventing the tumor to produce immunosuppressive factors that provide tumor cells to avoid being eliminated by the immune system and early surgery may also inhibits the initial site of metastases as well as removes non-vascularized areas where drugs could not reach previously [3], [6][7].…”

Section: Introductionmentioning

confidence: 99%

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Could Primary Tumor Resection Improve Survival in Metastatic Breast Cancer?

Oliveira

Goulart

et al. 2021

int.jour.sci.res.mana.

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Introduction: In advanced breast cancer, local treatment is considered palliative. However, although there are some polemic opinions about the surgical treatment, some of the latest studies have emphasized that in advanced cases primary tumor resection (PTR) is related to better outcomes. This review aims to evaluate how resection of the original tumor impacts women with metastatic breast cancer, considering the most recent studies about this subject. Methods: The search was performed in MEDLINE, Scopus, PMC, Current Contents and Wiley Online Library databases; 23 articles - from 2016 to 2019 - were selected and 11 were included in this review. As inclusion criteria were considered: studies presenting outcomes about resection of the primary tumor, comparison between chemotherapy/ hormone therapy/ targeted cancer therapies and surgical intervention, studies published from 2016 to 2019 and available in English, Spanish or Portuguese. We excluded those which did not approach PTR, did not present outcomes of interest (progression-free survival comparison between PTR and systemic therapy) or only discussed systemic therapy, as well as those published before 2016. Results: It was reported in 6 studies that progression-free survival is better on those who underwent surgery. PTR was also related to longer median overall survival in women submitted to surgery, up to 16 months higher when compared to the ones who were not. Enhanced survival even pertained to surgical groups regardless of tumor size. Conclusion: Based in the analysis, PTR in metastatic breast cancer can be related to higher overall survival.

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Metastatic castration‐sensitive prostate cancer: Abiraterone, docetaxel, or…

Barata

Sartor

2019

Cancer

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For decades, the management of patients with advanced prostate cancer has been hormonal therapy, known as androgen deprivation therapy, which is intended to lower testosterone levels. Further incremental progress in the treatment of men with metastatic hormone‐sensitive prostate cancer (mHSPC) has come from the addition of docetaxel or abiraterone acetate to androgen deprivation therapy for more aggressive upfront treatment regimens. Other combinatorial regimens testing the addition of novel therapies currently are in the late stages of development and are expected to further improve the clinical outcomes of these patients. The emergence of new positron emission tomography tracers specifically for prostate cancer, particularly prostate‐specific membrane antigen and fluciclovine, has increased the ability to detect metastatic disease earlier in the course of the disease and has helped to describe a new group of patients with mHSPC and oligometastatic disease. For this group of patients with mHSPC, the authors discuss the existing data with metastasis‐directed therapy and primary tumor‐directed therapy.

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Practical consensus recommendations regarding role of mastectomy in metastatic breast cancer

Cited by 7 publications

References 20 publications

Triple-negative breast cancer in Peru: 2000 patients and 15 years of experience

Triple-negative breast cancer in Peru: 2000 patients and 15 years of experience

Could Primary Tumor Resection Improve Survival in Metastatic Breast Cancer?

Metastatic castration‐sensitive prostate cancer: Abiraterone, docetaxel, or…

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