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

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Abstract

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.

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Authors and Affiliations

  1. John A. Burns School of Medicine, University of Hawaii, 651 Ilalo St., Honolulu, HI, 96813, USA

    Bevan H. Ly

  2. Radiation Oncology, University of Arizona, Tucson, AZ, 85724-5081, USA

    Nam P. Nguyen

  3. Vrije Universiteit Brussel, Elsene, Belgium

    Vincent Vinh-Hung

  4. Radiation Oncology, Geneva University Hospitals, Geneva, Switzerland

    Vincent Vinh-Hung

  5. Registre Genevois des Tumeurs, Geneva, Switzerland

    Elisabetta Rapiti

  6. Senology and Surgical Gynecologic Oncology, Geneva University Hospitals, Geneva, Switzerland

    Georges Vlastos

Authors
  1. Bevan H. Ly
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  2. Nam P. Nguyen
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  3. Vincent Vinh-Hung
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  4. Elisabetta Rapiti
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  5. Georges Vlastos
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Correspondence to Bevan H. Ly.

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Ly, B.H., Nguyen, N.P., Vinh-Hung, V. et al. Loco-regional treatment in metastatic breast cancer patients: Is there a survival benefit?. Breast Cancer Res Treat 119, 537–545 (2010). https://doi.org/10.1007/s10549-009-0610-z

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  • DOI: https://doi.org/10.1007/s10549-009-0610-z

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