Surgical treatment of the primary tumor in patients with stage IV breast cancer
Journal: Advances in Medicine and Engineering Interdisciplinary Research DOI: 10.32629/ameir.v4i2.5251
Abstract
Objective: To analyze the impact on survival in patients with stage IV breast cancer underwent surgical treatment of the primary tumor in the service of mammary pathology of our service in the period 2006-2016. Method: Retrospective, longitudinal study, analytical and descriptive. The sample consisted of 106 patients diagnosed with stage IV breast cancer, treated at the breast pathology service, meeting the inclusion criteria, taking into account the histories available in the medical histories service.All the patients fulfilled initial systematic treatment based on anthracyclines and taxanes, selecting 71 patients for surgical treatment. The tabulation and processing of the information was done through a database in excel, and statistical system SPSS22 . Results: 71 patients underwent surgery (66.98 %), 35 (33.2 %) only to chemotherapy. The most frequent histological subtype was the ductal 80.2%, 68.9% were T4, 43.4% N1, the most frequented site of metastasis was bone, oligo-metastatic 84%, the most performed surgery was total mastectomy 32.1%, not palliative 84%. The overall survive was 69.9 vs. 30.6 months inpatients operated and not operated. The progression free period was 47.3 in operated patients vs. 11.02 months in non-operated patients. Associated with the risk of death and survival, lymph node status, surgical treatment, metastasis in more than two organs and other than bone localization. Conclusion: This study showed benefit in terms of overall survive and free survival whiteout progression with the surgical treatment of the primary tumor.
Keywords
cancer; breast; stage IV; primary tumor surgery; survival
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[2] Rubio IT. Cirugía del tumor primario en cáncer de mama metastásico: ¿podemos contribuir a mejorar la supervivencia? Cir Esp. 2008;83(2):61-64.
[3] Khan SA, MD. Surgical management of the novo stage IV breast cancer. Sem Radiat Oncol. 2016;26(1):79-86.
[4] Quinn M, Kealy R, O'Meara S,Whelan M, Ennis R, Malone C, et al. Is there a role for locoregional surgery in stage IV breast cancer? Breast. 2015;24(1):32-37.
[5] Fisher B,Jeong J, Anderson S, Bryant J, Fisher E, Wolmark N. Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. N EnglJ Med.2002;347(8):567-575.
[6] Neumann HB, Morrogh M, Gonen M, Van Zee KJ, Morrow M, King TA. Stage IV breast cancer in the era of targeted therapy: Does surgery of the primary tumor matter? Cancer. 2010; 116(5):1226-1233.
[7] Nguyen DHA, Truong PT, Lesperance M, Alexander C, Walter CV, Hayashi E, et al. Can locoregional treatment of the primary tumor improve outcomes for women with stage IV breast cancer at diagnosis? IntJ Radiat Oncol Biol Phys. 2012;84:39-45.
[8] Kobayashi T, Ischia T, Sakuyama T,ArakawaY,Nagasaki E,Aiba K, et al. Possible clinical cure of metastatic breast cancer: Lessons from our 30-year experience with oligometastatic breast cancer patients and literature review. Breast Cancer. 2012;19(3):218-237.
[9] Rashaan ZM, Bastiaannet E, PortieljeJE, van de Water W, van der Velde S, Ernst MF, et al. Surgery in metastatic breast cancer: Patients with a favorable profile seem to have the most benefit from surgery. Eur J Surg Oncol.2012;38(1):52-56.
[10] Rapiti E, Verkooijen HM, Vlastos G, Fioretta G, Neyroud-Caspar I, Sappino AP, et al. Complete excision of primary breast tumor improves survival of patients with metastatic breast cancer at diagnosis. J Clin Oncol.2006;24(18):2743-2749.
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