TY - CHAP M1 - Book, Section TI - Local Therapy in the Setting of Metastatic Disease A1 - Margenthaler, Julie A. A1 - Cyr, Amy E. A2 - Morita, Shane Y. A2 - Balch, Charles M. A2 - Klimberg, V. Suzanne A2 - Pawlik, Timothy M. A2 - Posner, Mitchell C. A2 - Tanabe, Kenneth K. PY - 2018 T2 - Textbook of Complex General Surgical Oncology AB - Approximately 3.5% to 4% of women with newly diagnosed breast cancer are found to have stage IV disease at presentation according to the Surveillance, Epidemiology, and End Results (SEER) dataset.1 Despite the fact that this subgroup of patients comprise the minority of the total breast cancer population, this small fraction of breast cancer patients has inspired a heated debate in the literature and at national meetings, fueled by the rapid publication rate on this subject over the past decade. To date, all published reports on this topic are limited to retrospective reviews and meta-analyses. There are several hypotheses as to why extirpation of the primary breast tumor may or may not benefit overall disease-free progression and/or survival despite known distant metastatic sites. There is also a growing body of literature on the potential benefits of metastastectomy of isolated sites. These retrospective data have led to the development of three international, multi-institutional randomized trials to study this question. This chapter will review the published reports to date for both primary tumor removal and distant metastastectomy, discuss the potential beneficial and adverse biological events secondary to primary tumor resection, and summarize the randomized trials currently accruing patients. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/04 UR - accesssurgery.mhmedical.com/content.aspx?aid=1145760703 ER -