, Volume 16, Issue 5, pp 1437-1438
Date: 29 Jan 2009

Stage IV Breast Cancer: Is Surgical Resection of Clinical Utility?

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Should a surgical resection be performed for patients presented with stage IV breast cancer? The systemic nature of this stage does not support surgery. Instead, primary systemic treatment and radiation has been the standard approach.1 Recently, Gnerlich et al.2 analyzing the 1988–2003 Surveillance, Epidemiology, and End Results (SEER) program data of 9734 stage IV patients, concluded that resection of the primary tumor reduces mortality in patients with stage IV disease. Thus, surgical resection could be considered for these patients, although high-quality evidence for decision-making is lacking.

In a recent issue of the Annals of Surgical Oncology, Cady et al.3 report on a retrospective study of stage IV breast cancer patients treated with or without surgery. The authors concluded that case selection bias in primary breast cancer resection in state IV patients might explain most, if not all, the apparent survival advantage of such surgery. In this study the rate of stage IV disease wa ...