In patients with a de novo diagnosis of breast cancer with synchronous distant metastases , surgery and radiotherapy result in considerably better locoregional tumor control .
An improvement in survival has not been consistently proven , but may exist in subgroups of patients .
Bei Patientinnen mit primärer Fernmetastasierung führt die lokale Beh and lung mittels Operation und/oder Strahlentherapie zur besseren lokalen Tumorkontrolle .
Aim The purpose of this work is to give practical guidelines for radiotherapy of locally advanced , inflammatory and metastatic breast cancer at first presentation .
ZusammenfassungZielZiel der Arbeit ist die Entwicklung von Praxis-Leitlinien zur Strahlentherapie des lokal fortgeschrittenen einschließlich des inflammatorischen Mammakarzinoms sowie zur lokalen Therapie bei synchroner Fernmetastasierung .
Ein Überlebensvorteil besteht wohl nicht , möglicherweise aber doch für einige Subgruppen der Patientinnen .
Effect of Primary Tumor Extirpation in Breast Cancer Patients Who Present With Stage IV Disease and an Intact Primary Tumor
Background Currently , therapy for breast cancer patients with stage IV disease and an intact primary tumor is metastasis directed ; the primary tumor is treated only when it causes symptoms . A recent review suggested that surgery may improve long-term survival in such patients . We evaluated the effect of surgery in such patients on long-term survival and disease progression . Methods We review ed the records of all breast cancer patients treated at our institution between 1997 and 2002 who presented with stage IV disease and an intact primary tumor . Information collected included demographics , tumor characteristics , site(s ) of metastases , type/ date of operation , use of radiotherapy , chemotherapy and hormonal therapy , disease progression ( time to progression and location of progression ) in the first year after diagnosis , and last follow-up . Overall and metastatic progression-free survival were compared between surgery and nonsurgery patients . Results Of 224 patients identified , 82 ( 37 % ) underwent surgical extirpation of the primary tumor ( segmental mastectomy in 39 [ 48 % ] and mastectomy in 43 [ 52 % ] ) , and 142 ( 63 % ) were treated without surgery . The median follow-up time was 32.1 months . After adjustment for other covariates , surgery was associated with a trend toward improvement in overall survival ( P = .12 ; relative risk , .50 ; 95 % confidence interval , .21–1.19 ) and a significant improvement in metastatic progression-free survival ( P = .0007 ; relative risk , .54 ; 95 % confidence interval , .38–.77 ) . Conclusions Removal of the intact primary tumor for breast cancer patients with synchronous stage IV disease is associated with improvement in metastatic progression-free survival . Prospect i ve studies are needed to vali date these findings
In patients with a de novo diagnosis of breast cancer with synchronous distant metastases , surgery and radiotherapy result in considerably better locoregional tumor control .
An improvement in survival has not been consistently proven , but may exist in subgroups of patients .
Bei Patientinnen mit primärer Fernmetastasierung führt die lokale Beh and lung mittels Operation und/oder Strahlentherapie zur besseren lokalen Tumorkontrolle .
Aim The purpose of this work is to give practical guidelines for radiotherapy of locally advanced , inflammatory and metastatic breast cancer at first presentation .
ZusammenfassungZielZiel der Arbeit ist die Entwicklung von Praxis-Leitlinien zur Strahlentherapie des lokal fortgeschrittenen einschließlich des inflammatorischen Mammakarzinoms sowie zur lokalen Therapie bei synchroner Fernmetastasierung .
Ein Überlebensvorteil besteht wohl nicht , möglicherweise aber doch für einige Subgruppen der Patientinnen .