Place of surgery in early stage IV breast cancer

Early metastatic breast cancer is an aggressive disease. We carried out a retrospective study of 221 cases of stage IV breast cancer to assess the value of local surgery in metastatic breast cancer. One hundred and twenty-nine patients underwent surgery. Healthy margins were obtained in 76.1% of cases. Operated patients had a less advanced T stage (p=0.0001), fewer visceral metastases (p=0.0001) and fewer secondary lesions (p=0.001). After a median follow-up of 36 months, overall survival at 1, 3 and 5 years was better in the operated group (p=0.0001, p=0.002, p=0.019). In the case of isolated bone metastases, operated patients had better overall survival at 1, 3 and 5 years than non-operated patients (p=0.02, p=0.037, p=0.033). Surgical technique had no impact on overall survival or local recurrence. In sano surgery improved 5-year OS (p=0.047). In multivariate analysis, the factors influencing surgical outcome were the presence of visceral metastases, more than 3 metastases and tumour resection limits.