Factors determining survival in oligometastatic breast cancer in a retrospective cohort study from a low and middle income country

Metastatic breast cancer has historically had a poor prognosis, but oligometastatic breast cancer shows differing outcomes. We analyzed the factors affecting 5-year survival for patients undergoing upfront resection. We conducted a 10-year chart review from a tertiary referral hospital. Patients were followed for at least 5 years after surgery. Overall and progression free survival were calculated from date of surgery using cox-proportional hazards while logistic regression was used to evaluate the pre- and post-operative factors associated with surgery. 55 patients with a mean age of 50.4 years were included. Most patients had T4, N1/N2 stage disease on presentation. The most common site of metastasis was lungs. The median overall survival was 111 months with a 5-year survival rate of 64.6% (47.9%, 77.2%). There were 18 distant and 1 local recurrence and 20 deaths in our cohort leading to a median progression free survival of 36 months. N2 nodal disease, and liver metastasis were identified as poor prognostic markers while hormone receptors increased survival (p < 0.05), while locally advanced disease and triple positive tumor biology increased the risk of progression and death (p < 0.05). Patients with limited metastatic disease should be considered for upfront resection with the intent to cure, especially when triple positive tumor biology is present.