Romuald Le Scodan1, David Ali, Denise Stevens. 1. Department of Radiation Oncology, Institut Curie Hôpital René Huguenin, Saint Cloud, France. lescodan@crh1.org
Abstract
BACKGROUND: Data from the Surveillance, Epidemiology, and End Results program and the European Concerted Action on survival and Care of Cancer Patients (EUROCARE) project indicate that about 6% of women newly diagnosed with breast cancer have stage IV disease, representing about 12 600 new cases per year in the United States in 2005. Historically, local therapy of the primary tumor in this setting has been aimed solely at symptom palliation. However, several studies suggest that surgical excision of the primary tumor can prolong these patients' survival. DISCUSSION: Exclusive locoregional radiotherapy is an alternative form of locoregional treatment in this setting and may represent an effective alternative to surgery in this setting. Here we discuss current issues regarding exclusive and adjuvant locoregional radiotherapy in breast cancer patients with synchronous metastases. SUMMARY: Several studies suggest that surgery or exclusive irradiation of the primary tumor is associated with better survival in breast cancer patients with synchronous metastases and that exclusive locoregional radiotherapy may represent an effective alternative to surgery in this setting. Results of well-designed prospective studies are needed to re-evaluate treatment of the primary breast tumor in patients with metastases at diagnosis, and to identify those patients who are most likely to benefit.
BACKGROUND: Data from the Surveillance, Epidemiology, and End Results program and the European Concerted Action on survival and Care of CancerPatients (EUROCARE) project indicate that about 6% of women newly diagnosed with breast cancer have stage IV disease, representing about 12 600 new cases per year in the United States in 2005. Historically, local therapy of the primary tumor in this setting has been aimed solely at symptom palliation. However, several studies suggest that surgical excision of the primary tumor can prolong these patients' survival. DISCUSSION: Exclusive locoregional radiotherapy is an alternative form of locoregional treatment in this setting and may represent an effective alternative to surgery in this setting. Here we discuss current issues regarding exclusive and adjuvant locoregional radiotherapy in breast cancerpatients with synchronous metastases. SUMMARY: Several studies suggest that surgery or exclusive irradiation of the primary tumor is associated with better survival in breast cancerpatients with synchronous metastases and that exclusive locoregional radiotherapy may represent an effective alternative to surgery in this setting. Results of well-designed prospective studies are needed to re-evaluate treatment of the primary breast tumor in patients with metastases at diagnosis, and to identify those patients who are most likely to benefit.
Authors: J Ruiterkamp; M F Ernst; L V van de Poll-Franse; K Bosscha; V C G Tjan-Heijnen; A C Voogd Journal: Eur J Surg Oncol Date: 2009-04-26 Impact factor: 4.424
Authors: Roshni Rao; Lei Feng; Henry M Kuerer; S Eva Singletary; Isabelle Bedrosian; Kelly K Hunt; Merrick I Ross; Gabriel N Hortobagyi; Barry W Feig; Frederick C Ames; Gildy V Babiera Journal: Ann Surg Oncol Date: 2008-03-21 Impact factor: 5.344
Authors: Hannah W Hazard; Seema R Gorla; Denise Scholtens; Krystyna Kiel; William J Gradishar; Seema A Khan Journal: Cancer Date: 2008-10-15 Impact factor: 6.860
Authors: Andrea C Bafford; Harold J Burstein; Christina R Barkley; Barbara L Smith; Stuart Lipsitz; James D Iglehart; Eric P Winer; Mehra Golshan Journal: Breast Cancer Res Treat Date: 2008-06-26 Impact factor: 4.872