Resection of Primary Tumour Appears to Improve Outcomes in Advanced Breast Cancer: Presented at SABCS
By Alex Morrisson
SAN ANTONIO, Tex -- December 12, 2011 -- Among women who present with metastatic or advanced breast cancer, debulking the main tumour may improve clinical outcomes, researchers said here at the 34th San Antonio Breast Cancer Symposium (SABCS).
“The optimal management of local disease in patients with concurrent metastatic breast cancer is unknown,” said Sara Samiee, MD, Ottawa Regional Cancer Centre, Ottawa, Ontario, on December 8. “We found that removal of the intact primary tumour for breast cancer patients with synchronous stage 4 disease is associated with improvement in local disease and overall survival.”
The researchers found that local progression occurred in 28 of 64 women (43%) who were not treated with surgery, compared with 7 of 46 women (15%) who underwent surgery to remove the cancer (P <.001).
Median overall survival was 33 months for the women who did not receive surgery and 49 months for the women who underwent surgery (P =.016).
Dr. Samiee said that the results might be skewed because some of the women not selected for surgery may have had other comorbidities that would have kept them from being candidates for surgery.
In the single-centre study, the researchers reviewed data collected from 2005 through 2007 on women who presented with concurrent metastatic disease.
“About 10% of women present with concurrent metastatic disease,” said Dr. Samiee. “Controversy exists about the optimal local management of these patients.”
The mean age of the women in the study who did not receive surgery was 64 years versus 61 years for those who did undergo surgery (P =.196).
Most (~75%) of the women were hormone-receptor positive. About 13% of the women who did not have surgery and about 29% of the women who underwent surgery were human epidermal growth factor receptor 2 (HER2)-positive (P =.06).
Approximately 11% of the women had triple-negative breast cancer: oestrogen-receptor negative, progesterone-receptor negative, and HER2-negative.
“These results confirm the need for prospective studies using not only survival outcomes but also local-control and quality-of-life endpoints,” Dr. Samiee concluded.
[Presentation title: Excision of the Primary Tumour in Patients With Metastatic Breast Cancer - Will E2108 Provide the Definitive Answer? Abstract P2-15-05]
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