Pulmonary resection for metastatic breast cancer
E. D. Staren, C. Salerno, A. Rongione, T. R. Witt and L. P. Faber
Department of General Surgery, Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill.
Thirty-three patients treated primarily with surgical excision of pulmonary
metastases from breast cancer were compared with 30 patients treated
primarily with systemic chemohormonal therapy. Treatment for patients in
the surgical group included pulmonary resection alone in 20, resection plus
adjuvant systemic therapy in nine, and resection plus adjuvant radiation
therapy in four. Treatment for patients in the medical group included
systemic therapy alone in 22 and systemic therapy plus local radiation
therapy in eight. Mean survival in the surgical group was significantly
longer than that in the medical group, even when only those patients who
manifested single pulmonary nodules were compared (58 months vs 34 months).
The overall 5-year survival rate after treatment of lung metastasis was
significantly greater for the surgical group than for the medical group
(36% vs 11%). The results of this study indicate that surgical resection
should be considered in patients with breast cancer who develop operable
pulmonary metastases without evidence for concomitant extrapulmonary
disease. In selected patients, such therapy may result in a survival
benefit.
