Role of surgery in metastatic breast cancer

Purpose Surgery of the primary tumor usually is not advised for patient with metastatic breast cancer at diagnosis because the disease is considered incurable. The goals of treatment are the prolongation of life and palliation or prevention of symptoms. In this study we evaluate the effect of mastectomy on survival of patients with metastatic breast cancer. Methods In our study we reviewed records of(100 ) patients with stage IV breast cancer referred to clinical oncology department faculty of medicine zagazig university and Fakous cancer center between Jan 2012 to Jan 2014 , data collection include metastatic sites ,treatment and survival. And we evaluate effect of surgery of the primary breast tumor to those who had not surgery on survival and prognostic factor. Results From 100 patients, 35 patients had only bone metastases, 65 patients with visceral metastases. Groups had a 15 months median survival, 45 patients receive hormonal therapy and 55 patients had not received. Groups had 13 months median survival, 60 patients receive chemotherapy with median survival 24 months and 40 patients not receive chemotherapy with 9 months median survival, (p<0.02), 35 patients receive radiotherapy and 65 not receive with same median survival. 30 patients with surgery to the breast primary with 25 months median survival. While 70 patients without surgery to the primary tumor with 15 months median survival with p =0.05. Statistical analysis determined that chemotherapy is the only factor associated with improved survival p=0.02. While patients with hormonal therapy and radiotherapy had insignificant changes in survival .and the median survival became more significant with patients receive chemotherapy with excision of the primary tumor. Conclusion Complete surgical excision of the primary tumor improves survival of patients with metastatic breast cancer at diagnosis, especially among patients with only bone metastasis and with patients receives chemotherapy.