title: Role of breast surgery in T1-3 breast cancer patients with synchronous bone metastases.
abstract: The impact of breast surgery on survival of metastatic breast cancer (MBC) patients is controversial. We addressed the question in a mono-institutional series of MBC patients with synchronous bone metastases. We identified 187 consecutive women diagnosed between 2000 and 2008 with locally operable (T1-T3) MBC, synchronous bone metastases, with no other distant sites being involved. Progression-free survival (PFS) and overall survival (OS) were compared between operated and non-operated patients. Median age was 51 years; 92 % of the women had a hormone-positive tumor. At the time of diagnosis, 131 patients out of 187 (70 %) underwent surgery. Operated and non-operated patients differed in terms of number of bone metastatic sites: a single metastasis was detected in 35 (28 %) operated, and 6 (11 %) non-operated cases (P = 0.01). No other significant differences were observed. The multi-adjusted hazard ratio was 0.63 (95 % CI 0.43-0.92) for PFS and 0.64 (95 % CI 0.41-0.99) for OS in favor of surgery. The 5-year cumulative incidence of ipsilateral breast skin progressions among non-operated patients was 18 %. In this large and homogeneous series of MBC patients with synchronous bone metastases, the role of breast surgery had a favorable impact on both disease progression and mortality.
authors: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. edoardo.botteri@ieo.it
authors: Edoardo
authors: E
authors: Botteri
authors: Elisabetta
authors: E
authors: Munzone
authors: Mattia
authors: M
authors: Intra
authors: Vincenzo
authors: V
authors: Bagnardi
authors: Nicole
authors: N
authors: Rotmensz
authors: Barbara
authors: B
authors: Bazolli
authors: Bruno
authors: B
authors: Montanari
authors: Gaetano
authors: G
authors: Aurilio
authors: Angela
authors: A
authors: Sciandivasci
authors: Angela
authors: A
authors: Esposito
authors: Gianmatteo
authors: G
authors: Pagani
authors: Laura
authors: L
authors: Adamoli
authors: Giuseppe
authors: G
authors: Viale
authors: Franco
authors: F
authors: Nolè
authors: Aron
authors: A
authors: Goldhirsch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000556:secondary*; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D055815:Young Adult