Breast Cancer Research and Treatment

, Volume 119, Issue 3, pp 537-545

First online:

Loco-regional treatment in metastatic breast cancer patients: Is there a survival benefit?

  • Bevan H. LyAffiliated withJohn A. Burns School of Medicine, University of Hawaii Email author 
  • , Nam P. NguyenAffiliated withRadiation Oncology, University of Arizona
  • , Vincent Vinh-HungAffiliated withVrije Universiteit BrusselRadiation Oncology, Geneva University Hospitals
  • , Elisabetta RapitiAffiliated withRegistre Genevois des Tumeurs
  • , Georges VlastosAffiliated withSenology and Surgical Gynecologic Oncology, Geneva University Hospitals

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A number of studies have recently demonstrated a survival benefit in stage IV breast cancer patients following surgical resection of the primary tumor. Here, we investigate the relationship between loco-regional treatment and survival in patients with metastatic breast cancer and evaluate the impact of different loco-regional treatments. We conducted a systematic review of the literature using PubMed to analyze studies with the following criteria: Type of loco-regional treatment (surgery alone or combined with radiation, radiotherapy), overall survival, progression-free survival, selection factors for local treatment, and complication rates. Thirteen studies evaluated the effect of loco-regional treatment on overall survival with overall median survival increasing from a range of 12.6–28.3 months among patients without surgery to a range of 25–42 months among patients with surgery. In addition, six studies reported a 3-year survival benefit of 28–95% and 17–79% in women with and without loco-regional therapy respectively. Two studies did not find any improvement in overall survival. One study found an improvement in 5-year breast cancer-specific survival of 27% with negative surgical margins versus 12% with no surgery. Three studies reported an advantage in progression-free survival in the treatment group compared with the non-treatment group. Loco-regional treatment for breast cancer patients with distant metastases at diagnosis is an important issue because of possible improvement of survival or disease-free survival. The possibility of surgery and/or radiotherapy following induction chemotherapy should be weighed and left to individual practice. Participation in randomized controlled trials should be encouraged.


Stage IV breast cancer Survival Loco-regional treatment Surgery Radiotherapy