scholarly journals Local Resection of Primary Tumor in Upfront Stage IV Breast Cancer

Breast Care ◽  
2016 ◽  
Vol 11 (6) ◽  
pp. 411-417 ◽  
Author(s):  
Thomas Kolben ◽  
Theresa M. Kolben ◽  
Isabelle Himsl ◽  
Tom Degenhardt ◽  
Jutta Engel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Tumor ◽  
Univariate Analysis ◽  
Metastatic Breast ◽  
Local Therapy ◽  
Stage Iv ◽  
Organ System ◽  
Asymptomatic Patients ◽  
Local Surgery ◽  
Stage Iv Breast Cancer

Background: This study aimed to identify the association of local surgery of the primary tumor in metastatic breast cancer (MBC) patients with overall survival (OS) and prognostic factors. Patients and Methods: Patients with primary MBC (1990-2006) were included in our retrospective analysis (n = 236). 83.1% had surgery for the primary tumor. OS was evaluated using Kaplan-Meier estimates. Predictive factors for OS were determined. Results: Median follow-up was 123 months for all patients still alive at the time of analysis. In univariate analysis, patients with surgery of the primary tumor had significantly prolonged OS (28.9 vs. 23.9 months). Within the surgery group, patients with MBC limited to 1 organ system had a better outcome (39.3 vs. 24.9 months), as did asymptomatic patients. Independent risk factors for shorter OS were hormone receptor negativity, symptoms, and involvement of ≥ 1 organ system. Conclusion: Patient selection for local therapy was confounded by a more favorable profile and a lesser tumor burden before surgery, which might implicate a bias. Nevertheless, our univariate results indicate that local surgery of the primary tumor in MBC patients could be considered as part of the therapeutic regimen in selected patients. However, larger patient numbers are needed to prove these findings in the multivariate model.

A randomized controlled trial comparing primary tumor resection plus systemic therapy with systemic therapy alone in metastatic breast cancer (JCOG1017 PRIM-BC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. TPS588-TPS588 ◽  
Author(s):  
Tadahiko Shien ◽  
Tomonori Mizutani ◽  
Kiyo Tanaka ◽  
Takayuki Kinoshita ◽  
Fumikata Hara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systemic Therapy ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Metastatic Breast ◽  
Stage Iv ◽  
Primary Tumor Resection ◽  
Her2 Status ◽  
Free Survival ◽  
Stage Iv Breast Cancer

TPS588 Background: The possibility of improving the survival of stage IV breast cancer patients by primary tumor resection (PTR) has been reported by several retrospective studies; however, these studies essentially suffer from biases such as arbitrary patient selection, diverse timing of surgery or various regimens of systemic therapy. Five prospective randomized trials including our trial have evaluated the efficacy of PTR for them. Two have reported final results, but those results were inconsistent. Therefore, this subject still remains a hotly debated topic at major breast conferences. Methods: Our trial is being conducted to confirm the superiority of PTR plus systemic therapy over systemic therapy alone in stage IV pts who are sensitive to primary systemic therapy (PST) in this study. The inclusion criteria are untreated pts with histologically confirmed invasive breast cancer with one or more measurable distant metastatic lesions diagnosed by radiological examination.All pts receive PST according to the ER and HER2 status of the primary breast cancer after the first registration. After three months, the pts who are sensitive to PST are randomized to the PTR plus systemic therapy arm or the systemic therapy alone arm. After randomization and surgery in the former arm, or after randomization in the latter arm, the same systemic therapies are continued until progression of diseases and next appropriate regimens are started after that. The primary endpoint is the overall survival, and the secondary endpoints are proportion of pts without tumor progression at the metastatic sites, yearly local recurrence-free survival, proportion of local ulcer/local bleeding, yearly primary tumor resection-free survival, adverse events (AEs) of chemotherapy, operative morbidity, and serious AEs. Sample size for randomized pts was determined to attain at least 80% of power to detect a 6 months difference with one-sided alpha of 0.05.The pts accrual was started in May 2011. Enrollment of 410 pts for randomization is planned over a 7-year accrual period. 307 pts have been randomized until Jan 2017. This trial was registered at UMIN-CTR[umin.ac.jp/ctr/] as UMIN000005586. Clinical trial information: UMIN000005586.

Complications associated with erythropoietin stimulating agents (ESAs) in patients with metastatic breast cancer: A surveillance, epidemiology, and end results (SEER)–Medicare study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 1034-1034
Author(s):  
M. Chavez-Macgregor ◽  
S. Fang ◽  
T. P. Srokowski ◽  
G. N. Hortobagyi ◽  
S. H. Giordano
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Univariate Analysis ◽  
Metastatic Breast ◽  
Stage Iv ◽  
Median Number ◽  
Adverse Outcomes ◽  
Dose Effect ◽  
Curative Intent ◽  
Stage Iv Breast Cancer

1034 Background: Results of recent clinical trials suggest that the use of ESAs is associated with adverse outcomes. ESAs increase the risk for thrombotic events and have the potential of decreasing survival. Guidelines recommend the use of ESAs in patients with chemotherapy-induced anemia being treated with non curative intent. In this population-based study, we sought to evaluate the thromboembolic effects associated with the use of ESAs in patients receiving chemotherapy for metastatic breast cancer. Methods: Retrospective cohort study using the SEER-Medicare linked database. Patients with stage IV breast cancer diagnosed from 1995–2002, who were 66 and older, were treated with chemotherapy, and had full coverage of Medicare A and B were identified. Patients with end stage renal disease were excluded. ICD-9 and HCPCS codes were used to identify the use of ESAs, chemotherapy, comorbidities, and complications of therapy. Analyses were conduced using descriptive statistics, logistic regression, and Cox proportional hazard models. Results: 1411 women were included, 519 (36.8%) received ESAs and 892 (63.2%) did not; median age was 73 and 74 years old respectively. Median time from diagnosis to first ESA dose was 6 months, median number of ESAs doses was 8.5. In univariate analysis, patients receiving ESAs had higher rates of MI/CAD (38% vs 32.9% p = 0.051), thrombosis (32.4% vs 23.2% p = 0.0002), phlebitis (21.4% vs 12.6% p < 0.0001), and transfusion (37.76% vs 19.4% p < 0.0001), with no difference in the rate of stroke or pulmonary embolism. Multivariate analysis showed HR for MI/CAD 1.29 (1.01–1.66); thrombosis 1.5 (1.116–1.93), phlebitis 1.79 (1.32–2.43), and transfusion 2.65 (2.05–3.43). Significant dose effect was evident for the thrombosis and phlebitis outcomes for patients receiving more than 5 ESAs doses. Conclusions: The use of ESAs in patients with metastatic breast cancer increases the risk of thrombosis and phlebitis, with evidence of a dose-dependent effect. Patients receiving ESAs were more likely to have blood transfusions. These data support current practice of using ESAs for minimum necessary time to reduce risk of complications. No significant financial relationships to disclose.

Does local surgery have a role in the management of stage IV breast cancer?

2003 ◽  
Vol 29 (1) ◽  
pp. 17-19 ◽  
Author(s):  
A.R Carmichael ◽  
E.D.C Anderson ◽  
U Chetty ◽  
J.M Dixon
Keyword(s):  
Breast Cancer ◽  
Stage Iv ◽  
Local Surgery ◽  
Stage Iv Breast Cancer

Randomized Trial Comparing Resection of Primary Tumor with No Surgery in Stage IV Breast Cancer at Presentation: Protocol MF07-01

2018 ◽  
Vol 25 (11) ◽  
pp. 3141-3149 ◽  
Author(s):  
Atilla Soran ◽  
Vahit Ozmen ◽  
Serdar Ozbas ◽  
Hasan Karanlik ◽  
Mahmut Muslumanoglu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Trial ◽  
Primary Tumor ◽  
Stage Iv ◽  
Stage Iv Breast Cancer

Primary tumor resection in patients with stage IV breast cancer: 10‐year experience

2021 ◽  
Author(s):  
Malke Asaad ◽  
Jennifer A. Yonkus ◽  
Tanya L. Hoskin ◽  
Tina J. Hieken ◽  
James W. Jakub ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Stage Iv ◽  
Primary Tumor Resection ◽  
Stage Iv Breast Cancer

scholarly journals Difficulty Diagnosing a Brain Tumor during Clinical Maintenance of a Complete Response to anti-HER2 Treatments for Metastatic Breast Cancer: A Case Report

2020 ◽  
Vol 13 (3) ◽  
pp. 1311-1316
Author(s):  
Ryoko Semba ◽  
Yoshiya Horimoto ◽  
Atsushi Arakawa ◽  
Yoko Edahiro ◽  
Tomoiku Takaku ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Tumor ◽  
Ductal Carcinoma ◽  
Metastatic Breast ◽  
Stage Iv ◽  
B Cell Lymphoma ◽  
High Dose ◽  
Her2 Positive ◽  
Stage Iv Breast Cancer ◽  
The Right

A 46-year-old woman with erythema of the right breast presented to our hospital and was diagnosed with stage IV breast cancer (HER2-positive invasive ductal carcinoma). She received 4 courses of anthracycline-based regimens and 4 courses of trastuzumab + pertuzumab + docetaxel (Tmab + Pmab + DTX). Since she responded well to these therapies, only Tmab + Pmab was continued thereafter. Twenty-three months after starting treatment, she developed a headache. A tumor was identified in the right temporal lobe. Craniotomy was performed for definitive diagnosis. Intraoperative pathological assessment suggested the tumor to be brain metastasis of breast cancer. However, the final pathological diagnosis was diffuse large B-cell lymphoma of central nervous system (DLBCL-CNS) based on re-assessment with immunohistochemical examinations. Therefore, the Tmab + Pmab was discontinued, and 6 courses of high-dose methotrexate therapy were administered. This case highlights the importance of considering rare entities, such as DLBCL, when diagnosing a solitary brain tumor in a patient with a primary cancer, based on imaging and pathological findings.

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