- Surgical resection of the primary tumor in women presenting with stage IV breast cancer (BC) is typically recommended only for palliative treatment.
- This retrospective study found that surgical resection is also associated with 47% lower mortality.
Why this matters
- Surgical resection of the primary tumor in de novo stage IV BC should be considered for its survival benefits.
- Retrospective cohort of 313 women presenting with stage IV BC, of whom 60.1% underwent surgical resection of the primary tumor (usually modified radical mastectomy).
- Survival was compared between surgery and nonsurgery groups.
- Funding: None.
- The surgery group had longer median survival (78 months vs 37 months for the nonsurgery group); the mortality risk was cut by 47% after adjustment for clinical and tumor characteristics (adjusted HR, 0.53; 95% CI, 0.36-0.78).
- In stratified survival analysis, the following subsets of surgery patients had lower mortality:
- Bone metastasis only and primary tumor ≤5 cm (HR, 0.27; 95% CI, 0.08-0.90).
- Soft tissue metastasis only (HR, 0.21; 95% CI, 0.06-0.72).
- ≤3 metastatic sites (HR, 0.54; 95% CI, 0.36-0.81).
- Single-center study.
- Retrospective, nonrandomized design.