Surgical Treatment Of The Primary Tumor In Patients With Metastatic Breast Cancer (Stage Iv Disease)

385Surgical Treatment of the Primary Tumor in Patients with Metastatic Breast Cancer (Stage IV Disease)Mattia IntraThe widespread uptake of breast cancer screening, together with heightened population awareness, means that most breast cancers in the Western world are detected at an early stage. Recent tumor registry studies from the United States and Europe have shown that metastatic breast cancer (BC) accounts for 4-5% of all cases [1-3]. However, in develop-ing nations, the proportion of patients with metastatic BC at diagnosis is greater, ranging from 10% in Malaysia [4] to 24% in Nepal [5] and 44% in Nigerian women [6]. In early breast cancer, high-quality evidence from randomized con-trolled trials and meta-analyses is available to support the majority of treatments we perform. In comparison, there is a lack of level I evidence and accepted standard-of-care thera-pies available for patients with metastatic BC.Metastatic BC is considered to be a fatal disease, regard-less of whether distant metastases are discovered at initial presentation (de novo stage IV) or following apparently suc-cessful therapy of localized disease and an intervening disease- free interval (metachronous stage IV). As stage IV disease is considered incurable, the goals of treatment are only the prolongation of life and the palliation or