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. 2021 Sep;28(9):5048-5057.
doi: 10.1245/s10434-021-09621-8. Epub 2021 Feb 2.

The Effect of Primary Surgery in Patients with De Novo Stage IV Breast Cancer with Bone Metastasis Only (Protocol BOMET MF 14-01): A Multi-Center, Prospective Registry Study

Atilla Soran  1 , Lutfi Dogan  2 , Arda Isik  3 , Serdar Ozbas  4 , Didem Can Trabulus  5 , Umut Demirci  6 , Hasan Karanlik  7 , Aykut Soyder  8 , Ahmet Dag  9 , Ahmet Bilici  10 , Mutlu Dogan  11 , Hande Koksal  12 , Mehmet Ali Nahit Sendur  13 , Mehmet Ali Gulcelik  14 , Gokturk Maralcan  15 , Neslihan Cabioglu  16 , Levent Yeniay  17 , Zafer Utkan  18 , Turgay Simsek  18 , Nuri Karadurmus  19 , Gul Daglar  4 , Birol Yildiz  19 , Cihan Uras  20 , Mustafa Tukenmez  16 , Ahmet Yildirim  11 , Suat Kutun  2 , Cihangir Ozaslan  2 , Niyazi Karaman  21 , Müfide Nuran Akcay  22 , Osman Toktas  23 , Efe Sezgin  24
Affiliations

The Effect of Primary Surgery in Patients with De Novo Stage IV Breast Cancer with Bone Metastasis Only (Protocol BOMET MF 14-01): A Multi-Center, Prospective Registry Study

Atilla Soran et al. Ann Surg Oncol. 2021 Sep.

Abstract

Background: More evidence shows that primary surgery for de novo metastatic breast cancer (BC) prolongs overall survival (OS) in selected cases. The aim of this study was to evaluate the role of locoregional treatment (LRT) in BC patients with de novo stage IV bone only metastasis (BOM).

Methods: The prospective, multicenter registry study BOMET MF14-01 was initiated in May 2014. Patients with de novo stage IV BOM BC were divided into two groups: those receiving systemic treatment (ST group) and those receiving LRT (LRT group). Patients who received LRT were further divided into two groups: ST after LRT (LRT + ST group) and ST before LRT (ST + LRT group).

Results: We included 505 patients in this study; 240 (47.5%) patients in the ST group and 265 (52.5%) in the LRT group. One hundred and thirteen patients (26.3%) died in the 34-month median follow-up, 85 (35.4%) in the ST group and 28 (10.5%) in LRT group. Local progression was observed in 39 (16.2%) of the patients in the ST group and 18 (6.7%) in the LRT group (p = 0.001). Hazard of death was 60% lower in the LRT group compared with the ST group (HR 0.40, 95% CI 0.30-0.54, p < 0.0001).

Conclusion: In this prospectively maintained registry study, we found that LRT prolonged survival and decreased locoregional recurrence in the median 3-year follow-up. Timing of primary breast surgery either at diagnosis or after ST provided a survival benefit similar to ST alone in de novo stage IV BOM BC patients.

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