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Surgery may make sense for patients with advanced breast cancer

by Williams,Lauren R. last modified Jun 21, 2010 12:21 PM

May 20, 2010

LOUISVILLE, Ky. – Surgery to remove breast cancer tumors in patients who have been diagnosed with advanced disease may prolong survival slightly, according to a study led by researchers from the University of Louisville’s James Graham Brown Cancer Center.


“Surgery is not typically offered for patients with stage IV disease, because of the extent to which the cancer has spread to other parts of the body,” said Matthew Bower, MD, a surgical oncology fellow at the University of Louisville and lead investigator on the study. “However, our study looked at patients who were diagnosed with advanced disease, some of whom did undergo surgery of their primary tumor, and it appears that those who had their primary breast tumor removed survived 10 months longer than those who did not.”


The study results will be presented on a poster at the annual American Society of Clinical Oncology meeting in June in Chicago. The study was funded by the University of Louisville’s Department of Surgery and the James Graham Brown Cancer Center.


The researchers studied data from 1,906 patients with breast cancer treated between January 1996 and December 2007 at the University of Louisville’s James Graham Brown Cancer Center. Seventy-eight patients were identified as having presented with stage IV disease; the breast cancer had spread to distant sites in their bodies, including bone, liver, brain or multiple sites.


“Patients diagnosed with advanced cancer typically are treated with chemotherapy or hormonal therapy only, but there has been some speculation that surgery of the primary tumor might improve survival, and this study was designed to test that hypothesis,” said Anees Chagpar, MD, director of the breast multidisciplinary clinic at the James Graham Brown Cancer Center and senior investigator on the study. “The patients we looked at may have received surgery for local control or palliation despite having metastatic disease. But the results of our study demonstrate a slight survival advantage among these patients, which warrants further investigation.”


Patients in the study who received chemotherapy without surgery survived an average of 22 months after diagnosis while patients who received surgery to remove the primary breast tumor, as part of their treatment, survived an average of 32 months, Bower said.


Chagpar said that while the results of the study are interesting and could change the treatment plan for patients with metastatic breast cancer in the future, it is too early for these results to affect clinical practice now.


Other UofL investigators involved in this study include Charles Scoggins, Kelly McMasters, and Russell Brown.



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