Primary Surgery in Metastatic Breast Cancer

This study evaluated the effect of local-regional management of the primary tumor on the prognosis of patients with metastatic breast cancer. The primary outcome measure was overall survival, while progression-free survival was assessed as a secondary end-point.

We retrospectively analyzed metastatic breast cancer patients who underwent local-regional treatment over a 10-year period (May 2013 to May 2023). Sociodemographic and clinicopathological data were extracted from medical records and automated hospital systems. Statistical analyses were performed using SPSS.

The study cohort consisted of 76 patients, with a mean age of 50 years and a median follow-up period of 58 months. The progression-free survival rate was 58%, while overall survival reached 75%, and the 5-year survival rate was 80%. Importantly, no deaths were observed among patients who achieved a pathological complete response during follow-up. Analysis of survival outcomes revealed that overall survival was significantly reduced in patients with axillary lymph node metastasis compared to those without (p = 0.02), in individuals with triple-negative breast cancer compared to those with hormone receptor-positive tumors (p = 0.03), in patients with T4 tumors compared to those with other T stages (p = 0.04), and in patients who experienced recurrence or distant metastasis during follow-up relative to those who did not (p<0.01).

In metastatic breast cancer, surgical resection of the primary tumor was associated with improved overall survival and progression-free survival. While a response to systemic chemotherapy was a favorable prognostic factor, increased tumor size, axillary lymph node positivity, triple-negative status, and the development of new metastasis and/or recurrence during follow-up were associated with poorer outcomes.