Metastatic breast cancer is cancer that has spread beyond the breast to other parts of the body. Nearly 10% of women are diagnosed with metastatic disease when they are first diagnosed with breast cancer. Because the cancer has already spread, surgery is not always part of the treatment plan. Still, doctors sometimes recommend surgery to improve the overall response to treatment or to ease pain and other symptoms.
This study found that women with metastatic breast cancer at first diagnosis who had the breast tumor (the primary tumor) removed lived twice as long as women diagnosed with metastatic breast cancer who didn't have the primary tumor removed. Women who had surgery also were 40% more likely to be alive 5 years after diagnosis, compared to women who didn't have surgery:
The researchers looked the medical records of 728 women who had been diagnosed with metastatic breast cancer; 405 of the women had the primary tumor in the breast removed. The researchers compared the medical outcomes of the women who had surgery to women who didn't have surgery.
It's possible that the differences in survival time may have been because of differences between the women, rather than whether they didn't or didn't have surgery. Compared to the women who didn't have the primary tumor removed, women who had surgery were:
All of the above factors can influence survival rates. Still, the research results suggest that survival rates might improve for some women diagnosed with metastatic breast cancer if the primary tumor in the breast is removed. More research is needed so doctors can determine which women diagnosed with metastatic breast cancer would get the most benefits from surgery.
If you've just been diagnosed with metastatic breast cancer, you may want to talk to your doctor about the results of this study. If your doctor isn't recommending surgery as part of your treatment plan, ask why and how the details of your specific situation were considered in making treatment recommendations. If you have any doubts or concerns about the recommended treatment plan, you may want to get a second opinion. Most doctors are comfortable with patients getting a second opinion and can help you get one in a timely way.
You can learn more about treatments for metastatic breast cancer in the Treatments for Metastatic Breast Cancer pages.
Women with metastatic breast cancer at diagnosis lived twice as long if the primary tumor was removed, data from a large retrospective study showed.
Median survival was 31 months in women who had surgery versus 14 months in patients who did not have surgical removal of the primary tumor, according to a report at ECCO/ESMO, the joint European cancer congress. Surgery also doubled 5-year survival.
"Surgery is an independent prognostic factor for overall survival in patients with metastatic breast cancer," said Jetske Ruiterkamp, MD, of Jeroen Bosch Hospital in Den Bosch, The Netherlands.
"There is a reduction of mortality risk of 40% by removal of the primary tumor. A randomized, controlled trial should be performed for a more definitive conclusion."
As many as 10% of patients with newly diagnosed breast cancer have metastatic disease. Median survival is one to two years, and treatment focuses principally on maintaining or improving quality of life, Ruiterkamp noted.
Historically, local treatment for metastatic breast cancer has been restricted to patients with symptomatic primary tumors, she continued. However, recent studies have suggested that removal of the primary tumor may improve survival.
To examine the impact of surgery on survival of metastatic breast cancer, Ruiterkamp and colleagues reviewed data on 728 patients who had metastatic breast cancer at diagnosis. In 40% of cases, the primary tumor was surgically resected.
Five-year survival was 24.5% with surgery and 13.1% without (P<0.0001). In a multivariate analysis, surgery was associated with a mortality hazard ratio of 0.68 (95% CI 0.51-0.76).
The authors noted that surgically treated patients differed in several respects from those who did not have surgery. They were:
Disclosure information was not reported.
Primary source: European Journal of Cancer Supplements Source reference: Ruiterekamp J et al. "Surgical resection of the primary tumor is associated with improved survival in patients with distant metastatic breast cancer at diagnosis" Eur J Cancer Suppl 2009; 7(2): 261. Abstract O-5005.
Breastcancer.org 7 East Lancaster Avenue, 3rd Floor Ardmore, PA 19003
Learn more about our commitment to your privacy
© 2009 Breastcancer.org - All rights reserved.
Breastcancer.org is a non-profit organization dedicated to providing information and community to those touched by this disease. Learn more about our commitment to providing complete, accurate, and private breast cancer information.
_tcm8-332386.jpg "wellness_dvd_promo")