caa a22 4500 445336420 CHVBK 20180317142757.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1245/s10434-011-1592-8 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1592-8 Success and Failure of Primary Medical, Nonoperative Management In Breast Cancer [Elektronische Daten] [Seraina Schmid, Aleksandra Modlasiak, Mary Myrick, Nerbil Kilic, Carsten Viehl, Andreas Schötzau, Uwe Güth] Background: Nonoperative but systemic therapy as first-line management is offered to some patients with breast cancer (BC) who have assumed limited life expectancy, such as older women or those who have distant metastases at initial presentation. We evaluated rates of and predicting factors for success and failure of this therapy approach. Methods: Seventy-five patients who were initially treated only systemically, and cases in which local control while avoiding surgery was the intended long-term therapy goal were analyzed. Additionally, two stage-dependent subgroups were distinguished (A: stage I-III, n=31; B: stage IV, n=44). Failure of therapy was defined as when secondary surgery had to be performed due to locoregional progression or in case of no surgery when severe locoregional clinical signs/symptoms were observed during the further course. Results: Patients in group A were older than those in group B (81 vs. 67.5years; P<0.001) and showed an increased survival (5-year rates: 40.2% vs. 24.3%). In 24 patients of the entire cohort (32%), secondary surgery had to be performed; surgery was performed more often in group A (58.1% vs. 13.6%). In the cases in which no surgery was performed (n=51), 11 women (21.6%) suffered from severe locoregional symptoms in the palliative situation (A: n=1; B: n=10). Although the presence of stage IV was a significant factor for therapy success (odds ratio (OR), 2.59; 95% confidence interval (CI), 0.95-7.05; P=0.039), skin involvement was associated with failure of therapy (OR, 3.57; 95% CI, 1.16-11.11; P=0.031). Conclusions: Nonoperative treatment may be offered to selected patients with BC who have assumed limited life expectancy. These women must be openly informed that this approach is not successful in nearly half of the cases. Society of Surgical Oncology, 2011 Schmid Seraina Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Basel, Switzerland aut Modlasiak Aleksandra Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Basel, Switzerland aut Myrick Mary Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Basel, Switzerland aut Kilic Nerbil Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Basel, Switzerland aut Viehl Carsten Department of Surgery, UHB, Basel, Switzerland aut Schötzau Andreas Schötzau and Simmen Institute for Biomathematics, Basel, Switzerland aut Güth Uwe Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Basel, Switzerland aut Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2166-2172 1068-9265 18:8<2166 2011 18 10434 https://doi.org/10.1245/s10434-011-1592-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1592-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Schmid Seraina Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Basel, Switzerland aut NATIONALLICENCE 700 1- Modlasiak Aleksandra Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Basel, Switzerland aut NATIONALLICENCE 700 1- Myrick Mary Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Basel, Switzerland aut NATIONALLICENCE 700 1- Kilic Nerbil Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Basel, Switzerland aut NATIONALLICENCE 700 1- Viehl Carsten Department of Surgery, UHB, Basel, Switzerland aut NATIONALLICENCE 700 1- Schötzau Andreas Schötzau and Simmen Institute for Biomathematics, Basel, Switzerland aut NATIONALLICENCE 700 1- Güth Uwe Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Basel, Switzerland aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2166-2172 1068-9265 18:8<2166 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer