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Surgical Treatment for Metastatic Breast Cancer
Source: Breast Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 25, 2025 · Captured 2026-09-09.
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Context: Treatment of Metastatic Breast Cancer
The ECOG 2108 trial (NCT01242800) evaluated the potential benefit of breast locoregional interventions in patients with metastatic breast cancer. Women presenting with metastatic breast cancer and an intact primary tumor received systemic therapy for 4 to 8 months. If disease progression did not occur, patients were randomly assigned to receive locoregional therapy for the primary site (surgery and radiation therapy, per standards for nonmetastatic disease) or to continue systemic therapy. Of the 256 randomly assigned patients, 125 received early locoregional therapy. The primary end point was OS.[147]
The 3-year OS was 67.9% in the systemic therapy group and 68.4% in the locoregional therapy group (HR, 1.11; 90% CI, 0.82–1.52; P = .57). The median OS was 53.1 months (95% CI, 47.9–not estimable) in the systemic therapy group and 54.9 months (95% CI, 46.7–not estimable) in the locoregional therapy group.
Locoregional disease progression was less frequent in patients who received locoregional therapy (3-year locoregional progression rate, 16.3% vs. 39.8%; P < .001).
Surgery may be indicated for select patients. For example, patients may need surgery if the following issues occur:
Fungating/painful breast lesions (mastectomy).
Parenchymal brain or vertebral metastases with spinal cord compression.
Pathological (or impending) fractures.
Pleural or pericardial effusions.
For more information about pleural and pericardial effusions, see Cardiopulmonary Syndromes.
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