WASHINGTON, Dec. 2 (UPI) — Women with stage IV breast cancer are surviving at higher numbers and for longer, especially for women who have surgery to remove the cancer, researchers found in a large review of medical data.
Stage IV breast cancer is considered to be incurable, making management of the disease the primary goal of doctors. Between 5 and 10 percent of women have late-stage cancer with an intact tumor when diagnosed. Although managing the patient’s primary tumor is important, exactly what to do is debated and depends on individual doctors and patients.
As treatment has become more targeted and more effective, many doctors have moved away from performing mastectomy because it was not seen to improve a patient’s health situation. Based on the new research, however, that may not be true.
“Maybe we need to revisit this question of surgery,” said Mary C. Schroeder, an assistant professor in the College of Pharmacy at the University of Iowa and one of the authors of the study, told the Washington Post. “It may not be right for all women, but it may be better for some women than it was in 1995.”
Researchers reviewed medical records for 21,372 women diagnosed with stage IV breast cancer between 1988 and 2011, which were collected as part of the Surveillance, Epidemiology, and End Results study.
The researchers found the median survival of patients increased from 20 months among women diagnosed between 1988 to 1991 to 26 months for women diagnosed between 2007 and 2011.
During these years, surgery decreased significantly — 67.8 percent of women had it in 1988, versus 25.1 percent in 2011. The median survival of women who had surgery was higher, 28 months, as compared with 19 months for women who did not have surgery. And among patients who survived 10 years after their diagnosis, 9.6 percent of the women had surgery, compared to the 2.9 percent that did not have surgery.
Researchers caution any sudden change to recommendation for women diagnosed with late-stage breast cancer, calling it premature to say surgery will help women live longer considering everything else known about stage IV cancer.
“Randomized clinical trials and prospectively enrolled registries will be essential to understanding the underlying causal relationship between our observed association of receipt of surgery and improved survival,” researchers wrote in the study, which is published in the Journal of the American Medical Association.
“A large benefit for many women with stage IV breast cancer with surgery to the intact primary tumor is unlikely, especially as an ever-increasing array of more potent and targeted drugs may be able to provide better control or even eradication of systemic disease.”