RT Book, Section
A1 Margenthaler, Julie A.
A1 Cyr, Amy E.
A2 Morita, Shane Y.
A2 Balch, Charles M.
A2 Klimberg, V. Suzanne
A2 Pawlik, Timothy M.
A2 Posner, Mitchell C.
A2 Tanabe, Kenneth K.
SR Print(0)
ID 1145760703
T1 Local Therapy in the Setting of Metastatic Disease
T2 Textbook of Complex General Surgical Oncology
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071793315
LK hemonc.mhmedical.com/content.aspx?aid=1145760703
RD 2024/04/20
AB Approximately  3.5%  to  4%  of  women  with  newly  diagnosed  breast  cancer  are  found  to  have  stage  IV  disease  at  presentation  according  to  the  Surveillance,  Epidemiology,  and  End  Results  (SEER)  dataset.1  Despite  the  fact  that  this  subgroup  of  patients  comprise  the  minority  of  the  total  breast  cancer  population,  this  small  fraction  of  breast  cancer  patients  has  inspired  a  heated  debate  in  the  literature  and  at  national  meetings,  fueled  by  the  rapid  publication  rate  on  this  subject  over  the  past  decade.  To  date,  all  published  reports  on  this  topic  are  limited  to  retrospective  reviews  and  meta-analyses.  There  are  several  hypotheses  as  to  why  extirpation  of  the  primary  breast  tumor  may  or  may  not  benefit  overall  disease-free  progression  and/or  survival  despite  known  distant  metastatic  sites.  There  is  also  a  growing  body  of  literature  on  the  potential  benefits  of  metastastectomy  of  isolated  sites.  These  retrospective  data  have  led  to  the  development  of  three  international,  multi-institutional  randomized  trials  to  study  this  question.  This  chapter  will  review  the  published  reports  to  date  for  both  primary  tumor  removal  and  distant  metastastectomy,  discuss  the  potential  beneficial  and  adverse  biological  events  secondary  to  primary  tumor  resection,  and  summarize  the  randomized  trials  currently  accruing  patients.