McGuire KP, Eisen S, Rodriguez A et al.
Moffitt Cancer Center, Tampa, FL, USA.
Am J Surg 2009;198:511–5.
Editor’s note: Traditionally, removal of the primary tumor in the setting of metastatic breast cancer has not been associated with improved survival, and mortality in this setting was thought to be driven by distant disease rather than the local tumor. Thus, in the past, treatment of stage IV breast cancer, even in the setting of an intact primary tumor, has involved systemic therapy. Surgical intervention and radiotherapy have only been used for palliation or prevention of local symptoms. However, some recent studies have suggested that surgical treatment of the primary tumor may improve outcomes in patients with metastatic breast cancer. On the other hand, other studies have negated the benefit of debulking the primary tumor in the setting of metastatic disease, indicating that doing so may even be detrimental. The present study was designed to review data on patients treated at a single center with metastatic breast cancer and compare overall survival (OS) between those who underwent breast-conserving surgery (BCS), those who had a mastectomy, and those who did not have surgery for the primary tumor.