title: Exclusive and adjuvant radiotherapy in breast cancer patients with synchronous metastases.
abstract: BACKGROUND
  Data from the Surveillance, Epidemiology, and End Results program and the European Concerted Action on survival and Care of Cancer Patients (EUROCARE) project indicate that about 6% of women newly diagnosed with breast cancer have stage IV disease, representing about 12 600 new cases per year in the United States in 2005. Historically, local therapy of the primary tumor in this setting has been aimed solely at symptom palliation. However, several studies suggest that surgical excision of the primary tumor can prolong these patients' survival.
  
  
  CONCLUSIONS
  Exclusive locoregional radiotherapy is an alternative form of locoregional treatment in this setting and may represent an effective alternative to surgery in this setting. Here we discuss current issues regarding exclusive and adjuvant locoregional radiotherapy in breast cancer patients with synchronous metastases.
  
  
  CONCLUSIONS
  Several studies suggest that surgery or exclusive irradiation of the primary tumor is associated with better survival in breast cancer patients with synchronous metastases and that exclusive locoregional radiotherapy may represent an effective alternative to surgery in this setting. Results of well-designed prospective studies are needed to re-evaluate treatment of the primary breast tumor in patients with metastases at diagnosis, and to identify those patients who are most likely to benefit.
authors.affiliation: Department of Radiation Oncology, Institut Curie Hôpital René Huguenin, Saint Cloud, France. lescodan@crh1.org
authors.forename: Romuald
authors.initials: R
authors.lastname: Le Scodan
authors.forename: David
authors.initials: D
authors.lastname: Ali
authors.forename: Denise
authors.initials: D
authors.lastname: Stevens
mesh_terms: D000818:Animals; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005060:Europe; D005260:Female; D006801:Humans; D008495:Medical Oncology / Q000379:methods*; D009362:Neoplasm Metastasis; D011878:Radiotherapy / Q000379:methods; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D012107:Research Design; D016896:Treatment Outcome