Certain advanced breast cancer patients may benefit from surgery before other treatment, study finds

Patients newly diagnosed with advanced breast cancer and a solitary bone metastasis could benefit from surgery prior to other treatment, according to early results from a first-of-its kind clinical trial presented today at the 2013 San Antonio Breast Cancer Symposium.

"In the U.S., approximately 5 percent of are diagnosed with advanced disease when they first see their physician," said Atilla Soran, M.D., a breast surgical oncologist with Magee-Womens Hospital of UPMC and the study's lead investigator. "Around the world, that percentage can go as high as 10 percent. Current standard of care recommends avoiding surgery in these patients and prescribing systemic therapy and radiation therapy instead. Previous research, however, has shown that surgery can actually prolong survival in other advanced cancers and we wanted to see if the same held true for breast cancer."

As a Turkish native, Dr. Soran approached the Turkish Federation of Societies for Breast Diseases about conducting a clinical trial to test the of such a treatment approach. In 2007, under scientific advisement with UPMC, the trial launched.

The study enrolled 278 patients with from across Turkey, 140 of whom underwent surgery. The primary goal of the study was to assess whether early surgical treatment in women with advanced disease could affect overall survival.

"Our initial results don't show any difference in survival rates, but we are early in the follow-up phase," said Dr. Soran. "However, we did notice that one patient subgroup – patients with a singular metastasis to the bone – is trending toward prolonged survival."

Patients with aggressive forms of the disease, and patients with multiple metastases on the liver and lungs, derived less benefit from the treatment approach.

"Breast cancer isn't just a U.S. concern – it's a global disease. We will continue our follow-up and reporting from this clinical trial for several years to come, and hopefully our study will help women here at home and abroad by improving our understanding of how to best treat it," said Dr. Soran.

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