title: Primary tumor excision in stage IV breast cancer at diagnosis without influence on survival: a retrospective analysis and review of the literature.
abstract: BACKGROUND
  Patients with synchronous metastastic breast cancer and intact primary tumor traditionally undergo systemic treatment. Surgical intervention at the primary site is typically reserved for palliation and often replaceable by radiation. Nevertheless, local surgery in metastatic breast cancer has become an issue of great controversy since retrospective studies published during the recent years suggested a slight benefit from an operative procedure. We evaluated the effect of surgery on long-term survival and progression-free survival in synchronous stage IV breast cancer.
  
  
  METHODS
  We retrospectively reviewed the records of all breast cancer patients treated at our institution between 1986 and 2007. Information recorded for each patient included age, tumor characteristics, metastasis characteristics, therapy, progression-free survival, and overall survival. Survival data were compared between surgical and nonsurgical patients.
  
  
  RESULTS
  61 patients with synchronous metastastic breast cancer and intact primary tumor were analyzed. 26 patients (43%) received no primary site surgery and 35 (57%) patients had surgery. Overall survival and progression-free survival determined via the Kaplan-Meier method showed no significant difference between the surgery and the non-surgery group.
  
  
  CONCLUSIONS
  In patients with metastatic breast cancer, the operation of the primary tumor did not influence overall survival or progression-free survival.
authors: Klinik für Onkologie und Hämatologie, Charité - Universitätsmedizin Berlin, Germany. marleen.rosche@charite.de
authors: Marleen
authors: M
authors: Rosche
authors: Anne-Constanze
authors: AC
authors: Regierer
authors: Sandra
authors: S
authors: Schwarzlose-Schwarck
authors: Andrea
authors: A
authors: Weigel
authors: Nikola
authors: N
authors: Bangemann
authors: Jan H
authors: JH
authors: Schefe
authors: Christian W
authors: CW
authors: Scholz
authors: Kurt
authors: K
authors: Possinger
authors: Jan
authors: J
authors: Eucker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality* / Q000601:surgery*; D002277:Carcinoma / Q000401:mortality* / Q000556:secondary* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008408:Mastectomy / Q000401:mortality*; D008875:Middle Aged; D009367:Neoplasm Staging; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome