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Eur J Surg Oncol. 2013 Nov;39(11):1192-8. doi: 10.1016/j.ejso.2013.08.015. Epub 2013 Sep 10.

Disease-related surgery in patients with distant metastatic breast cancer.

Author information

1
Cantonal Hospital Winterthur, Department of Gynecology and Obstetrics, Brauerstrasse 15, CH-8401 Winterthur, Switzerland; Breast Center "SenoSuisse", Brauerstrasse 15, CH-8401 Winterthur, Switzerland.

Abstract

INTRODUCTION:

This study evaluates the frequency of and indications for disease-related surgical procedures in the palliative breast cancer (BC) situation.

PATIENTS & METHODS:

Based on a cohort of women who were treated for newly diagnosed BC during a 20-year period (1990-2009), we analyzed 340 patients who developed distant metastatic disease (DMD) until 2011 and died (i.e. still ongoing palliative disease courses were not included).

RESULTS:

One hundred and twenty-seven surgical procedures were performed in 100 patients (29.4% of all patients with metastatic disease). The most common site for surgery was breast (n = 60, 47.2%). The primary tumor was removed at first diagnosis of DMD in 43 patients (33.9%); sixteen operations (12.6%) were performed for local recurrence. In 37 patients, 50 surgical procedures (39.4%) were necessary to stabilize osseous structures due to metastases. Procedures were rarely performed on other common metastatic sites: lung: n = 1 (0.8%); liver: n = 1 (0.8%), brain: n = 4 (3.1%). When excluding surgery for primary breast tumors at initial diagnosis of DMD from analysis, 34 of 84 surgeries (40.4%) were performed in the first third of survival follow-up (i.e. period of metastatic disease survival); operations in the last two-thirds each totaled 29.8% (n = 25). The median survival after surgery was 16 months (range: 0.5-89 months).

CONCLUSIONS:

In a cohort of BC patients who had primary or developed secondary DMD, nearly one third of the patients received disease-related surgical procedures during their palliative disease course. This high rate of operations shows that surgery has a clearly established role in the palliative therapy concept.

KEYWORDS:

Breast cancer; Distant metastases; Palliative situation; Surgery

PMID:
24029666
DOI:
10.1016/j.ejso.2013.08.015
[Indexed for MEDLINE]

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