title: Does local surgery have a role in the management of stage IV breast cancer?
abstract: OBJECTIVE
  There are no uniformly agreed guidelines regarding the treatment of local breast cancer in patients who have stable metastatic disease. The aim of this study was to define the role of breast surgery in the management of stage IV disease by reviewing the clinical outcome in patients with stage IV disease submitted to surgery in a regional breast cancer unit.
  
  
  METHODS
  All patients who underwent breast surgery from 1993 to 1999 and had known metastatic disease or who were diagnosed with metastases within one month of surgery were identified and their clinical outcome was studied using death and local recurrence as end points.
  
  
  RESULTS
  Median survival after breast surgery was 23 months. Ten of the 20 patients were alive with no local disease at 20 months mean follow-up. Three of 10 patients who died developed local recurrence and had local disease at the time of death.
  
  
  CONCLUSIONS
  The local surgery does have a role in controlling the primary cancer and controlling local symptoms in a selected group of patients with stable metastatic disease.
authors.affiliation: Edinburgh Breast Unit, Western General Hospital, Edinburgh, Scotland, UK. homepac@doctors.org.uk
authors.forename: A R
authors.initials: AR
authors.lastname: Carmichael
authors.forename: E D C
authors.initials: ED
authors.lastname: Anderson
authors.forename: U
authors.initials: U
authors.lastname: Chetty
authors.forename: J M
authors.initials: JM
authors.lastname: Dixon
mesh_terms: D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008593:Menopause; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000401:mortality / Q000601:surgery; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D016387:Women's Health