OP5 Stage IV breast cancer: Factors affecting survival rates in a tertiary institution, a 7-year experience

Abstract

Introduction Surgery has a conflicting role in the management of metastatic breast cancer. Recent literature suggests that surgery may confer a survival benefit to patients with stage IV disease. We compared the outcomes of surgery to other treatment modalities in the management of these patients in our institution between 2012 and 2018 and its effect on overall survival. Methods A retrospective study of metastatic breast cancer patients was conducted using logbook data and the SHARE Multidisciplinary Meeting data management system at Sir Charles Gairdner Hospital (SCGH) between 2012 and 2018. We included female patients aged 18 or over who were diagnosed with metastatic Stage IV breast cancer. We correlated data on treatment modalities, metastatic burden and associated life expectancy within this cohort. Results 81 out of 3003 patients with breast cancer managed at our institution had stage IV disease averaging 11.6 cases per year. The median survival was 72 months in the operative group in comparison to 20 months in the non-operative group. 22 out of 56 patients with oligo-metastatic disease died within our study period with a median survival of 24 months whilst 13 out of 25 patients with poly-metastatic disease died with a median survival of 21 months. 5 patients declined all form of treatment with a median survival of 7.5 months. Conclusion In our institution, surgery conferred a survival benefit compared to the non-operative group. Patients who declined all forms of treatment expectedly demonstrated the shortest median survival. The burden of metastatic disease at time of diagnosis did not influence overall survival.