Dr. Alla Aleksandrovna Bozhok
1Russian Society of Oncomammologists, Russia
Dr. Alla Bozhok has completed her PhD in oncology from N.N.Petrov Research Institute of Oncology – one of the oldest and the most famous institute in Russia in this field. She is an expert in the field of surgical and systemic treatment of breast cancer. Her main research interests are focused on breast cancer surgery, aesthetic and reconstructive surgery of the breast, systemic treatment of early and metastatic breast cancer. She is known for her research in the field of evaluating the effectiveness of various types of breast cancer systemic therapy including targeted treatment. Dr.Bozhok has published more than 90 papers in reputed journals, she is Board member and Academic Secretary of Russian Association of Oncomammologists. Recent years of professional work of Dr.Alla Bozhok have been devoted to the investigation of the effectiveness of surgery in metastatic breast cancer.
Breast cancer (BC) remains one of the most challenging problems in clinical oncology since it still has the highest incidence rate among all malignant tumors in women around the world. A significant number of breast cancer patients in the world (8.3%) and in Russia particulary (11.5%) are first diagnosed at stage IV.
There are many publications proving the feasibility of surgical treatment in certain patients with metastatic BC. To date, there is no clear understanding of the importance of cytoreductive surgery in treating BC dissemination.
Materials and Methods
This study covers the analysis of treatment outcomes in 608 patients with newly diagnosed advanced breast cancer between 1990 and 2015 as reported by 5 health care institutions in Russian Federation. The study and control groups were recruited retrospectively. The study group comprised patients with newly diagnosed ABC who underwent primary tumor surgery were receiving systemic anticancer therapy. Patients in the control group were receiving only systemic anticancer therapy. The groups were composed by pairwise matching, i. e. each patient in the study group was matched with a control patient of similar prognostic characteristics. As a result, groups comparable by localization and number of metastases, and tumor biological characteristics were created.
321 patients were included into the study group (surgical treatment and systemic therapy) and 287 patients were included into the control group (systemic anticancer therapy only).
The statistical analyses showed statistically significant differences in favor of study group.
The median survival was 35 months for the study group and 23 months for the control group (p < 0.01).
Surgical removal of primary tumor in newly diagnosed advanced BC results in statistically significant increase in the median survival from 23 to 35 months (p = 0.01).
The most impressive effect of surgical treatment is observed in patients with bone metastases, one or two metastatic lesions in one organ, positive response to systemic treatment, high expression of ER/PR and in cases where it is possible to attain clean resection margins.