Lane WO, et al. - Researchers assessed patterns of surgical care and their association with overall survival among women diagnosed with clinical stage IV breast cancer from 2003 to 2012, identified from the American College of Surgeons National Cancer Database. With respect to treatment sequence, they categorized women with intact primary tumors who were alive 12 months after diagnosis, as follows: (1) surgery before systemic therapy, (2) systemic therapy before surgery, and (3) systemic therapy alone. Almost half of women with stage IV breast cancer alive 1 year after diagnosis had undergone surgical resection of the primary tumor occurs, increasingly after systemic therapy. They observed improved adjusted overall survival in independent correlation with the receipt of surgery, whether before or after systemic therapy, when compared to systemic therapy alone. In the setting of metastatic breast cancer, where surgical decisions should be made on an individual basis and may affect survival in select women, the coordinated multidisciplinary care remains significant.