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According to an early online publication in the Journal of Clinical Oncology, the surgical removal of the original tumor in the breast significantly improves survival at five years among women with metastatic breast cancer, particularly those with cancer spread to the bone.

Breast cancer claims the lives of approximately 40,000 women annually in the U.S. alone. Metastatic breast cancer refers to cancer that has spread from the breast to distant sites in the body. Since metastatic breast cancer is not considered curable, standard treatment is aimed at improving the duration of survival while maintaining quality of life.

Standard treatment for metastatic breast cancer includes chemotherapy, targeted, and/or hormone therapy. Since the cancer has already spread from the breast in patients with metastatic breast cancer, surgical removal of the original tumor is not considered standard therapy for these patients, unless the tumor in the breast is causing discomfort or physiologic problems.

Researchers from Switzerland recently conducted a study to evaluate the potential effects on survival of removing the original cancer in the breast in women initially diagnosed with metastatic breast cancer.

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This study included 300 women in the Geneva Cancer Registry between 1977 and 1996; their initial diagnosis was metastatic breast cancer. The researchers compared survival between the patients who had their original cancer surgically removed to those who did not have surgery.

  • Women whose original cancer in the breast was completely surgically removed with no evidence of cancer cells in the surrounding area (negative surgical margins) had a 50% reduced risk of dying from breast cancer than women whose original cancer was not surgically removed.
  • At five years 27% of women who had their original cancer in the breast completely removed with negative surgical margins had not died from breast cancer.
  • At five years 16% of women who underwent surgery to remove their original tumor, but had evidence of cancer cells surrounding the surgical specimen (positive surgical margins) had not died from breast cancer.
  • At five years 12% of women who did not undergo surgery to remove their original cancer had not died from breast cancer.
  • Women with cancer spread to the bone derived the greatest survival benefit from the surgical removal of their original cancer in their breast.
  • Women who had their axillary (under the arm) lymph nodes removed during surgery derived greater survival benefit than those whose axillary lymph nodes were not removed.

These researchers concluded that the complete surgical removal with negative margins of the original breast cancer may significantly improve survival in patients diagnosed with metastatic breast cancer. They speculate that the improvement in survival may be due to reducing the total cancer burden on the patient’s body through surgery. Further study is necessary to confirm these findings and potentially bring this practice into standard care.

Reference: Rapiti E, Verkooijen H, Vlastos G, et al. Complete Excision of Primary Breast Tumor Improves Survival of Patients With Metastatic Breast Cancer at Diagnosis. Journal of Clinical Oncology. Published one-line ahead of print May 15, 2006. DOI: 10.1200/JCO.2005.04.2226.

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