Dr. Mamounas on Surgery in Stage IV Breast Cancer

Eleftherios (Terry) P. Mamounas, MD, MPH, Medical Director, Northeastern Ohio Universities College of Medicine, Medical Director, Aultman Hospital Cancer Center, discusses the controversial topic of surgery for patients who present with stage IV breast cancer at the time of diagnosis.

Traditionally, Mamounas explains, patients who are diagnosed with stage IV breast cancer are treated with palliative therapy. In general, at this stage, surgery is only performed for symptom management and to improve quality of life. However, some early studies have suggested that early local therapy with surgery may improve outcomes. Inherent in these early studies is a bias, Mamounas notes, since surgery is usually only performed on patients with minimally metastatic stage IV breast cancer.

To examine if surgery is efficacious in this population, the randomized phase III ECOG 2108 trial was formed and is currently enrolling patients, Mamounas points out. This trial will evaluate the value of early surgery compared to standard palliative therapy in treating patients with stage IV breast cancer (Find out more about ECOG 2108).