Surgery May Improve Stage 4 Breast Cancer Survival Rate, Study Finds

April 19, 2019

Surgery may be tied to improved chances of survival in stage 4 breast cancer patients, a new study suggests. Researchers found that tumor-removing surgery improves stage 4 breast cancer patients’ chances of survival by 44% within 21 months after the surgery.

The study, which was presented at the American Association for Cancer Research’s annual meeting in Atlanta this month, involved data on 3,231 women with HER2-positive stage 4 breast cancer. The data was collected from the National Cancer Database between 2010 and 2012.

According to the data, 89.4% of patients were treated with immunotherapy or chemotherapy, 37.7% of patients were treated with endocrine therapy, and 31.8% of patients were treated with radiation therapy. Only 35% of patients underwent surgery.

Researchers pointed out that patients who have access to surgery and those who don’t can vary drastically based on income level and administered treatment. Surgery was more likely to be performed on patients with private insurance or Medicare than those who were on Medicaid or were uninsured.

“If breast surgery is to be considered by patients and providers when deciding treatment strategy, it will be imperative to address significant disparities among patients who are offered surgical therapy,” said researchers.

Dr. Sharon Lum, the senior author of the study, said that surgery was also more likely to be performed on younger patients and white non-Hispanic patients.

The study also looked into where surgery fits in with other treatment options available to breast cancer patients. Screening alone through the use of mammography can reduce the risk of dying from breast cancer between 20% and 40%.

Ross Mudgway, the first author of the study, says search findings suggest that surgery to remove breast cancer tumors ought to be considered in addition to standard targeted medications and other therapies.

“We hope that our results encourage clinicians to consider surgical treatment in the face of metastatic disease while weighing the risks and potential benefits in this particular subset of patients who have new, effective targeted therapy options,” said Mudgway.

However, Mudgway points out that the study did have its limitations. One limitation was that researchers found there was only an association found between surgery and survival.

The data didn’t include any specific information such as which other targeted therapies were used among patients or if the patients adopted different lifestyle habits after their surgery.

For instance, exercise such as gymnastics, which has been around for more than 2,000 years, has been proven to reduce the risk of developing health conditions breast cancer. Health problems associated with obesity are considered to be the second leading cause of preventable death.

The researchers also don’t yet have randomized controlled trial results, which would address the direct impact of surgically removing the breast tumor.

Surgery has been a standard part of treating breast cancer alongside medications and radiation. But for those with stage 4 metastatic breast cancer, surgery hasn’t been a priority because cancer also exists in other parts of the body.

“The patients who had surgery were the ones who had better responses to chemotherapy, probably had less metastatic disease and were probably healthier,” said Dr. Monica Morrow, who wasn’t involved in the study. “So maybe they lived longer because of surgery, or maybe they would have lived longer anyway, and the study shows that doctors know how to identify patients who will do well.”

Morrow says that more research would need to be done to determine whether those factors are influencing the new study’s findings. Databases, she says, can sometimes suffer from selection bias. The only way to tell if surgery can benefit stage 4 breast cancer patients is if there’s a randomized trial.





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