Abstract
Although they cannot be considered curative, the new therapeutic integrated advances in metastatic breast cancer (MBC) have substantially improved patient outcomes. Traditionally, surgery was confined to palliation of symptomatic or ulcerating lumps. Data suggest, in some cases, a possible additive role for more aggressive locoregional surgical therapy in combination with systemic treatments in the metastatic setting, although a low level of evidence has been shown in terms of improvement in overall survival in MBC patients treated with surgery and medical treatment compared to medical treatment alone. In this light, tumor heterogeneity remains a challenge. To effectively reshape the therapeutic approach to MBC, careful consideration of who is a good candidate for locoregional resection is paramount. The patient’s global health condition, impacting on cancer progression and morbidity and their associated molecular targets, have to be considered in treatment decision-making. In particular, more recently, research has been focused on the role of metabolic derangements, including the presence of metabolic syndrome, which represent well-known conditions related to breast cancer recurrence and distant metastasis and are, therefore, involved in the prognosis. In the present article, we focus on locoregional surgical strategies in MBC and whether concomitant metabolic derangements may have a role in prognosis.
Highlights
The prevalence of metastatic breast cancer (MBC) is about 3–6% in the United States [1], affecting 15,000 women annually [2], and it is estimated that 3–8% of patients with newly diagnosed breast cancer have distant metastases as an initial presentation [3]
Several clinical studies were conducted in the past few years to clarify the impact and role of locoregional surgical treatment in patients affected by MBC
In the present article, we focus on locoregional surgical strategies in MBC and whether concomitant metabolic derangements may have a role in clinical outcomes
Summary
The prevalence of metastatic breast cancer (MBC) is about 3–6% in the United States [1], affecting 15,000 women annually [2], and it is estimated that 3–8% of patients with newly diagnosed breast cancer have distant metastases as an initial presentation [3]. Rao et al reported that MBC patients who had undergone breast surgery and the appropriate extent of axillary surgery had improved outcomes in terms of overall survival compared with patients who only had resection of the primary tumor and/or limited axillary surgery [15] In this light, several clinical studies were conducted in the past few years to clarify the impact and role of locoregional surgical treatment in patients affected by MBC. The clinical management of metabolic derangements in MBC does not represent consolidated clinical practice, despite the available experimental and clinical evidence indicating their roles in negatively impacting the prognosis in the MBC setting In this light, in the present article, we focus on locoregional surgical strategies in MBC and whether concomitant metabolic derangements may have a role in clinical outcomes
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