Surgery Lengthens Lives In Stage 4 Breast Cancer

Surgery for removing the primary tumor in women diagnosed with stage IV breast cancer, followed by the standard combination of therapies, adds months to patients’ lives, a new study shows.

Principal investigator Atilla Soran, clinical professor of surgery at the University of Pittsburgh School of Medicine, and a breast surgical oncologist, says:

“Our findings will change the standard of care for women newly diagnosed with stage IV breast cancer. We’ve shown that surgery to remove the primary tumor—either through lumpectomy or mastectomy—followed by standard therapy, is beneficial over no surgery.”

Researchers began the trial in 2007, ultimately recruiting a total of 274 women newly diagnosed with stage IV breast cancer from 25 institutions. Half the women received standard therapy, which avoids surgery and includes a combination of chemotherapy, hormonal therapy, and targeted therapy, while the other half first had surgery to remove their primary breast tumor, followed by the standard therapy.

At about 40 months after diagnosis, the women who received the surgery plus standard therapy lived an average of nine months longer than their counterparts who received standard therapy alone.

Nearly 42 percent of the women who received surgery lived to five years after diagnosis, compared with less than 25 percent of the women who did not receive surgery.

“Our thinking is similar to how you might approach a battle against two enemies,” Soran says. “First you quickly dispatch one army—the primary tumor—leaving you to concentrate all your efforts on battling the second army—any remaining cancer.”

The trial also showed that surgery in younger women with less aggressive cancers resulted in longer average survival than in women with more aggressive cancers that had spread to the liver or lungs.

Atilla Soran, et al
A randomized controlled trial evaluating resection of the primary breast tumor in women presenting with de novo stage IV breast cancer: Turkish Study (Protocol MF07-01)
J Clin Oncol 34, 2016 (suppl; abstr 1005)

Photo: by Priscilla Westra