[Role of palliative surgery in complex treatment for disseminated breast cancer]

An assessment was undertaken of survival and prognosis in 30 patients with primary disseminated breast tumors which disintegrated following palliative mastectomy carried out for sanitary purposes. That resulted in significant improvement in general condition, higher hemoglobulin and lowered intoxication which in turn made medication and radiotherapy possible: chemotherapy (4-6 cycles) followed by hormonal therapy (22-73.3%), hormonal therapy (8-26.7%), and radiotherapy for surgical scar (16-53.3%). All patients were followed up for 18 months (median--3.8 years). Tumor progression at different stages was detected in 12 (40%); local recurrences--8 out of them (26.7%). By the time of investigation, 9 (20%) out of 30, had died of tumor progression while 21 (80%) continued their treatment at the Institute's Clinic. Mean survival was 21.5 +/-2.2 months (median--19 (8-60+)). Our method proved effective due to high survival (median--18 months) and significant improvement in quality of life. However, visceral metastases (p = 0.02) and tumor growth duration (p = 0.05) were of prognostic significance. Such characteristics as presence or absence of estrogen and progesterone receptors of tumor, histological pattern, and anemia appeared insignificant, as far as prognosis was concerned. Function chi2 difference was highly significant (Cox) (p = 0.00013).