Abstract 5570
Background
De novo metastatic breast cancer (dnMBC) represents 6–10% of breast cancer. Due to its incurability, dnMBC is generally treated with systemic therapies to achieve disease control and reduce tumor-related symptoms. The need for radical loco-regional treatment and its consequent benefit in this setting remains still controversial. Meta-analysis of retrospective studies and prospective randomized studies did not report a clear survival benefit. The aim of this study was to analyze the impact of surgery to primary tumor (PT) in patients (pts) presenting with dnMBC.
Methods
Between Feb 2006-Oct 2015 we performed a retrospective chart review to 129 consecutive pts who attended our hospital with dnMBC. Descriptive, Kaplan-Meier and Cox regression analyses were carried out using SPSS version 23.0.
Results
A total of 129 pts. were analyzed. Median age was 68 years (range: 20-95), 59 pts (46%) had single organ metastasis, and their distribution according to the predominant site of disease was: skin/soft tissue 42 pts (33%), bone 87 pts (67%) and visceral 85 pts (66%). Surgery (S) of the PT was done in 32 pts (25%), 24 was radical procedures, 8 palliative and besides, 27 pts underwent axillary dissection. Initial S treatment was the choice for 29 pts. In the S group single organ disease was present in 66% vs 39% non-S group. Metastatic sites were: 50% vs 71% visceral, 44% vs 21% with bone metastasis in the S vs non-S group respectively. With a median follow-up of 2 years (SD 2.20), the 5-yr overall survival (OS) was 11.64% in the entire de novo MBC population, with a median OS of 36 m in the S-group vs 21 m. in the non-S-group (HR 1.46 p = 0.081). Subgroup analyses did not show a benefit of PT surgery in OS regardless of the number of metastasis and site of disease, and BC subtypes. The multi-adjusted HR for surgery was 0.14 (p = 0.188). The multivariate Cox regression analysis model included the site of disease (p = 0.971), the histopathologic grade (p = 0.876) and the hormone receptor status (p = 0.003).
Conclusions
In our series, surgical treatment of the primary tumor in patients with de novo metastatic breast cancer did not show a benefit in overall survival. Results of ongoing randomized trials are needed.
Clinical trial identification
Legal entity responsible for the study
Medical Oncology Service, Basurto University Hospital.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
1449 - Prognostic factors associated with pathological complete response in early breast cancer patients undergoing neoadjuvant chemotherapy. The importance of Ki-67 and molecular subtype.
Presenter: Bernardo Rapoport
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
4023 - The accuracy of sentinel lymph node biopsy following neoadjuvant chemotherapy in clinically node positive breast cancer patients: A single institution experience
Presenter: Narges Sistany Allahabadi
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
4707 - Index BRCA1/2 testing under a multidisciplinary program
Presenter: Duarte Machado
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
3393 - BRCA1/BRCA2 germline mutations and chemotherapy-related hematological toxicity in breast cancer patients
Presenter: Alex Friedlaender
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
3175 - PALB2 germ-line mutations in Russian breast cancer patients: identification of recurrent alleles and analysis of phenotypic characteristics of the tumors
Presenter: Evgeny Imyanitov
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
3027 - Landscape of germline mutations in hereditary breast and ovarian cancer (HBOC) patients in Russia revealed by target panel sequencing
Presenter: Elena Shagimardanova
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
4963 - Lynch syndrome-associated hereditary mutations cause breast and ovarian cancer: results from Russian Heredetary Oncogenomics project
Presenter: Marat Gordiev
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
2916 - Impact of deleterious germline BRCA mutations, addition of taxanes and use of adjuvant endocrine therapy (ET) on anti-müllerian hormone (AMH) levels in early breast cancer (EBC) patients treated by adjuvant chemotherapy (CT)
Presenter: Nathalie OLYMPIOS
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
2400 - Germline mutation status and therapy response in patients with triple-negative breast cancer (TNBC): Results of the GeparOcto study
Presenter: Esther Pohl
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
1345 - BRCA1/BRCA2 Predictive Genetic Testing in an Irish Population: A Missed Opportunity
Presenter: David O Reilly
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract