title: The role of surgery in breast cancer patients with isolated bone metastases at the time of diagnosis.
abstract: BACKGROUND
  Surgery for the primary tumor in breast cancer patients with synchronous isolated bone metastasis is applied for palliation. The aim was to determine whether surgical removal of the primary tumor provides a better survival and disease progression.
  
  
  METHODS
  Forty-four patients were diagnosed between the dates June 2004 and January 2007 and these patients are classified according to the removal of the primary tumor or not. Patients and tumor characteristics, removal of the primary tumor, and response to systemic therapy are examined as the factors that were affecting overall survival and time to progression of the disease.
  
  
  RESULTS
  The median follow-up time was 37.5 months. Mean time to progression and overall survival was longer for the patients who received surgery than the patients who did not (20.4 vs. 18.4 months and 57.6 vs. 44.5 months, respectively), but these were not significant (P = 0.58, P = 0.39). In multivariate analysis, response to systemic treatment [(P = 0.03), hazard ratio = 0.44, 95% confidence interval = 0.20-0.93] was independent factor associated with overall survival.
  
  
  CONCLUSIONS
  The response to systemic therapy is the major factor on survival in the breast cancer patients with isolated bone metastasis. Excision of the primary tumor has no effect on time to progression and overall survival.
authors.affiliation: Department of General Surgery, Ankara Oncology Education and Research Hospital, Demetevler/Ankara, Turkey. turanlisevim@hotmail.com
authors.forename: Sevim
authors.initials: S
authors.lastname: Turanli
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000556:secondary*; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D015996:Survival Rate; D013997:Time Factors