Primary Surgery in Metastatic Breast Cancer.

OBJECTIVE: This study evaluated the effect of local-regional management of the primary tumor on the prognosis of patients with metastatic breast cancer. The primary outcome measure was overall survival, while progression-free survival was assessed as a secondary end-point. MATERIALS AND METHODS: We retrospectively analyzed metastatic breast cancer patients who underwent local-regional treatment over a 10-year period (May 2013 to May 2023). Sociodemographic and clinicopathological data were extracted from medical records and automated hospital systems. Statistical analyses were performed using SPSS. RESULTS: The study cohort consisted of 76 patients, with a mean age of 50 years and a median follow-up period of 58 months. The progression-free survival rate was 58%, while overall survival reached 75%, and the 5-year survival rate was 80%. Importantly, no deaths were observed among patients who achieved a pathological complete response during follow-up. Analysis of survival outcomes revealed that overall survival was significantly reduced in patients with axillary lymph node metastasis compared to those without (p = 0.02), in individuals with triple-negative breast cancer compared to those with hormone receptor-positive tumors (p = 0.03), in patients with T4 tumors compared to those with other T stages (p = 0.04), and in patients who experienced recurrence or distant metastasis during follow-up relative to those who did not (p<0.01). CONCLUSION: In metastatic breast cancer, surgical resection of the primary tumor was associated with improved overall survival and progression-free survival. While a response to systemic chemotherapy was a favorable prognostic factor, increased tumor size, axillary lymph node positivity, triple-negative status, and the development of new metastasis and/or recurrence during follow-up were associated with poorer outcomes.