Gotta love this title: metastatic brst cancer as an incurable disease: a tenet with a

[Lani]

NEED FOR REVISION, And this study, hot off the press, reviewed patients diagnosed between 1990 and 1999. As mindsets change, perhaps as patients are followed more carefully with imaging capable of diagnosing metastasis sooner, perhaps by adding bone marrow biopsying early and frequently to discover mets when there are only a few disseminated tumor cells and phenotyping (characterizing) the micromets or circulating tumor cells early to determine which pathways are their Achilles's heels, with targetted treatments of cancer stem cells perhaps this 3% can be expanded. I would like to have seen how herceptin and Cyberknife use changed the average survival in their metastatic patients with oligo(few)metastatic disease. Those longterm Stage IV survivors who contribute to this board certainly amount to more than 3 % of those with Stage IV MBC I would think.

Cancer J. 2009 January/February;15(1):81-86.

Distant Metastatic Breast Cancer as an Incurable Disease: A Tenet With a Need for Revision.

Güth U, Huang DJ, Dirnhofer S, Rochlitz C, Wight E.
From the *Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Spitalstrasse 21, Basel CH-4031, Switzerland; daggerInstitute of Pathology, University of Basel, Schönbeinstrasse 40, Basel CH-4031, Switzerland; and double daggerDepartment of Medical Oncology, UHB, Petersgraben 4, Basel CH-4031, Switzerland.
PURPOSE:: Published reports provide level-III evidence in support of the hypothesis that distant metastatic breast cancer (MBC) might be curable in up to 3% of cases through a multidisciplinary approach including combination chemotherapy regimens in selected patients, usually young, and with limited metastases. Our study evaluates the rate and characteristics of long-term survivors based on a nonselective study cohort. PATIENTS AND METHODS:: We analyzed the data from 149 patients in whom distant MBC was diagnosed from 1990 to 1999. RESULTS:: Five patients (3.4%) were long-term survivors (9-14 years after initial diagnosis of MBC) without any clinical evidence of disease. They had a 2-peaked distribution of age: 3 were 41-57 years old at the diagnosis of MBC and 2 were much older (76, 79 years). Median survival time after diagnosis of MBC was 152 (range, 109-172) months. Three patients had isolated metastatic lesions, although 1 patient had multiple organ metastases and another extensive bone metastases. In 4 of 5 cases, long-term survival was achieved without the administration of chemotherapy. DISCUSSION:: Long-term survivors in MBC comprise a relatively heterogeneous group, and the factors which lead to the quite rare situation of long-term survival can hardly be evaluated systematically. Aggressive chemotherapy regimens appear not to be a key factor for survival. Furthermore, in a nonselective study cohort, some patients clearly are not only alive but also disease-free more than 12 years after initial relapse. This fraction may be small, but the chance for survival, and even for cure, truly exists.
PMID: 19197181