375P - Breast Carcinoma with Distant Metastasis at Initial Presentation: Impact of Breast Surgery in Real-Life Clinical Practice

Abstract

ABSTRACT Aim: About 5–10% of breast cancer (BC) patients (pts) are metastatic breast carcinoma (MBC) at diagnosis. Systemic therapy is the usual initial approach in this setting. Radical locoregional surgery is still controversial. The present study aims to assess the use and impact of breast surgery in MBC outcome in real-life clinical practice. Methods: Retrospective series of cases of MBC at diagnosis admitted in our Institution between 1995 and 2008. Medical records were reviewed with collection of demographic and clinical variables. Population characterization was performed using descriptive statistics. Survival analysis was assessed through Kaplan-Meier and log-rank test for subgroups comparison. Uni and multivariate analysis for prognostic variables was accomplished by Cox proportional hazard model Results: We identified 326 MBC pts at presentation (3% of all BC pts). Median age was 59 yr (range 20-91). Most pts (238 - 75%) had positive hormonal receptors (HR) and 130 (44%) were cT4. Visceral metastases were identified in 134 pts. Surgery was the first treatment in 79 pts (24%), while the majority (71%) were initially treated with systemic approach. Among pts treated initially with systemic therapy, 50% were submitted to surgery afterwards. Fifteen pts (5%) were proposed for best supportive care upfront. Median overall survival (OS) was 21 months, with 5-year survival of 20% (95% CI 17,6-24,4). Patients submitted to surgery present the best OS rates, either if performed as initial therapy (27vs20 months, p = 0,003) or after systemic therapy (38vs10 months, p Conclusions: The present review confirms the common use of breast surgery in real-life practice for MBC at diagnosis, with a favourable impact in outcome. Our data suggest that the best timing for breast surgery is after systemic treatment, supporting the importance of distant metastasis control before locorregional treatment Disclosure: All authors have declared no conflicts of interest.