ASO Author Reflections: Reconstruction in the Metastatic Breast Cancer Patient—Shifting Focus to Quality of Life

Excerpt

The literature is split regarding the benefits of mastectomy in the metastatic breast cancer population. There are many conflicting studies, some showing survival benefit from surgery, and others not.1^,2 Selection bias, retrospective data, lack of rigorous propensity-matched analyses, and non-uniform patient populations explain some of the difficulties encountered in studying this important question. Without definitive trial data, it has not been standard of care to perform primary tumor resection for a metastatic breast cancer patient, and, as such, the trend for breast reconstruction in the metastatic population has never been explored. Metastatic breast cancer patients are living longer as a result of improved therapies,3 with appropriate escalation and de-escalation of cytotoxic therapies in favor of targeted approaches balancing life prolongation and quality of life. Using a large clinical oncology population registry, we set out to investigate the trends of breast reconstruction in the metastatic population, rates of complications, and survival outcomes in an effort to provide clinicians with information to appropriately counsel this patient population. …