[Significant extension of survival by complete resection of isolated lung metastases after breast carcinoma].
At least 25% of breast cancer patients develop distant metastases. In spite of increasingly sophisticated palliative therapies, the survival time of patients with metastasis did not appear to be significantly prolonged during the last 25 years (19-32 months following diagnosis) and 95% of them die from metastatic disease. Therefore, it seems appropriate that the therapeutic risk/benefit ratio and impact on quality of life should be reassessed when asymptomatic patients are treated. Surgical treatment and pulmonary resection for metastatic disease has been proven a valuable therapeutic concept for a variety of malignancies. Three epidemiologically comparable collectives out of a total of 125 patients from our clinic were treated for isolated pulmonary metastasis following breast cancer (observation period: 1977-1997). Complete data sets could be established for 96 patients and were retrospectively analyzed following stratification into three groups according to their surgical therapy. Twenty-eight patients underwent complete resection (K), 34 had incomplete resections (I) and 34 had no surgical intervention for lung metastases (N). Comparison of the three therapy arms concerning stage, histology and receptor levels of the primary tumor, number of metastases, and the disease-free interval yielded no significant differences between groups K, I and N. Patients after complete resection of isolated lung metastases (group K) had a mean survival of 79 months (5-year survival 80%, 10-year survival 60%). This was significantly better than groups I and N (P < 0.00002). The mean survival of groups I and N was not significantly different (15.5 and 9 months respectively). The disease-free interval after operation of the primary tumor had no impact on the survival of group K, but showed a high correlation with the survival of group N (R2 = 0.81). Complete resection of isolated pulmonary metastases from carcinoma of the breast results in marked prolongation of survival with a low morbidity rate. Hence, routine chest X-ray should be considered an indispensable part of the oncological aftercare in breast cancer patients.
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Klinische Abteilung für Allgemeinchirurgie, Universitätsklinik für Chirurgie, Universität Wien.
Murabito
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Groeger
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Staffen
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Müller
M R
MR
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery; D018275:Carcinoma, Lobular / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery; D018572:Disease-Free Survival; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D019057:Quality-Adjusted Life Years; D013249:Sternum / Q000601:surgery; D015996:Survival Rate; D013908:Thoracotomy