Advances in locoregional surgical treatment of

Purpose: Breast cancer is the most common malignancy among women worldwide. A notable subset of patients presents with Methodology: Recent retrospective and prospective studies on locoregional surgery for Results: Most retrospective studies and meta-analyses report that primary breast surgery is associated with improved prognosis when stage IV disease is first diagnosed. However, significant selection bias exists in these data. Women who undergo surgery tend to be younger, have smaller primary tumors, fewer comorbidities, and lower metastatic burden-particularly fewer visceral metastases. They are also more likely to receive higher-quality overall care. These factors suggest that surgeons preferentially select patients with a better expected prognosis for surgery. In contrast, prospective randomized trials have consistently failed to demonstrate that locoregional surgery provides additional survival benefits beyond systemic therapy alone. Consequently, routine locoregional surgical treatment is not recommended for most patients with Conclusion: Although retrospective analyses support a survival advantage from locoregional surgery in