ASO Author Reflections: Improved Survival for Stage IV Breast Cancer: Considerations for Surgery in the Era of HER2-Targeted Therapy

Excerpt

Due to their risk of dying from complications of distant metastatic sites, women with stage IV breast cancer have traditionally only been offered surgical resection of the primary breast tumor in cases requiring local wound management. Mixed results from numerous retrospective studies and prior randomized controlled trials have led to continued debate and lack of a practice standard to guide whether the primary breast tumor should be removed in patients with stage IV breast cancer.1 Breast tumor expression of human epidermal growth factor receptor 2 (HER2) was initially considered a poor prognostic feature; however, outcomes for patients with HER2+ breast cancer have dramatically improved with the development of HER2-targeted therapies.2 Previous studies examining the survival benefit from surgery for stage IV breast cancer patients were completed prior to the routine use of anti-HER2 therapies, and studies focusing on the efficacy of surgery on survival exclusively in the HER2+ stage IV breast cancer patient population are limited. …