Effect of Surgery or Radiotherapy of the Breast on Survival in Metastatic Disease: a Retrospective Cohort Study.

Evidence to justify survival benefit of local therapy of the breast (LT) for breast cancer patients who are metastatic at presentation (MBC) is weak. The aim of this study is to evaluate the outcome of LT on survival in MBC patients. Patients who had received (1) radiotherapy, (2) surgery, (3) surgery and radiotherapy as LT, and (4) no LT in four groups of 25 were evaluated for 1- and 4-year cause-specific survival (CSS). One- and 4-year CSS in four groups were (1) 76% and 60%, (2) 84% and 56% (3) 80% and 52%, and (4) 48% and 16%, respectively. When controlling for age and site of metastasis as covariates, grouping significantly correlated with survival: F (3, 94): 2.93, P 0.04. Post hoc analysis revealed that the mean survival of group 2: (M 23.39, SE 2.53) was higher than group 4: (M 13.63, SE 2.52, P = 0.03). Surgery as a single modality LT for MBC may provide survival benefit.