Annals of Surgical Oncology

, Volume 17, Issue 9, pp 2419–2426 | Cite as

Metastasectomy and Surgical Resection of the Primary Tumor in Patients With Stage IV Breast Cancer

Time for a Second Look?
  • Barbara A. Pockaj
  • Nabil Wasif
  • Amylou C. Dueck
  • Dennis A. Wigle
  • Judy C. Boughey
  • Amy C. Degnim
  • Richard J. Gray
  • Sarah A. McLaughlin
  • Donald W. Northfelt
  • Robert P. Sticca
  • James W. Jakub
  • Edith A. Perez
Breast Oncology


Patients with metastatic or stage IV breast cancer have limited therapeutic options, and the mainstay of treatment remains systemic chemotherapy. Traditionally, the role of surgery has been confined to strict palliation. Improvements in the efficacy of chemotherapeutic regimens, coupled with the use of hormonal and targeted therapy, have resulted in an expansion of surgical resection beyond simple palliation. Several single-institution studies have reported improved survival and even long-term cures after surgical resection for oligometastatic stage IV breast cancer. Similarly, provocative new data suggest that removal of the primary tumor in some patients may confer a survival advantage. The aim of this review is to summarize studies in the medical literature pertaining to the use of surgical resection in patients with stage IV breast cancer. We believe there is enough evidence to challenge conventional thinking about the role of surgery in stage IV breast cancer and to consider a new multimodality treatment paradigm to optimize patient outcomes. It is time to conduct a carefully designed randomized trial to see whether surgery in stage IV breast cancer does indeed warrant a second look.


Breast Cancer Metastatic Breast Cancer Systemic Therapy Hepatic Resection Partial Mastectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Society of Surgical Oncology 2010

Authors and Affiliations

  • Barbara A. Pockaj
    • 1
  • Nabil Wasif
    • 2
  • Amylou C. Dueck
    • 3
  • Dennis A. Wigle
    • 2
  • Judy C. Boughey
    • 2
  • Amy C. Degnim
    • 2
  • Richard J. Gray
    • 1
  • Sarah A. McLaughlin
    • 4
  • Donald W. Northfelt
    • 5
  • Robert P. Sticca
    • 6
  • James W. Jakub
    • 2
  • Edith A. Perez
    • 7
  1. 1.Department of SurgeryMayo ClinicScottsdaleUSA
  2. 2.Department of SurgeryMayo ClinicRochesterUSA
  3. 3.BiostatisticsMayo ClinicScottsdaleUSA
  4. 4.Section of General SurgeryMayo ClinicJacksonvilleUSA
  5. 5.Division of Hematology and OncologyMayo ClinicScottsdaleUSA
  6. 6.Department of SurgeryUniversity of North Dakota School of Medicine and Health SciencesGrand ForksUSA
  7. 7.Division of Hematology and OncologyMayo ClinicJacksonvilleUSA

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