1. Evidence Based Approach 5-Year Survival Rate for Breast Cancer Stage IV is 14% 2 to 5 percent become long-term survivors, possibly cured of their disease. [1,2] These long-term survivors tend to be young, with an excellent performance status, and limited metastatic (sometimes referred to as oligometastatic) For such patients, combined modality approaches, often including surgery, appear to provide a better chance for long-term progression-free survival than chemotherapy alone

2. Evidence Based Approach Complete resection of isolated lung metastasis from breast carcinoma results in a strong increase in survival Authors: Murabito M; Salat A; Mueller Publication: Minerva Chir 2000 Mar;55(3):121-7. Results: Comparison of the three therapy methods concerning stage, histology and receptor levels of the primary tumor, number of metastases and the disease free interval (DFI), as well as adjuvant therapy modalities yielded no significant differences. Treatment Groups: C complete resection, 28 patients; I, incomplete resection, 34 patients; N, no resection, 34 patients

3. Evidence Based Approach Mean survival of group C was with 79 months (5- years-survival 80%, 10-years-survival 60%) significantly better compared to groups I and N (p < 0.00002). Mean survival of group I and N was not significantly different (15.5 and 9 months respectively). Conclusions: Routine chest X-ray is necessary in the follow-up of breast cancer patients and if coin lesions occur, thoracic surgeon should be contacted.

4. Reference 1.Greenberg, PA, Hortobagyi, GN; Smith, TL, et al. Long-term follow-up of patients with complete remission following combination chemotherapy for metastatic breast cancer. J Clin Oncol 1996; 14:2197.Greenberg, PA, Hortobagyi, GN; Smith, TL, et al. Long-term follow-up of patients with complete remission following combination chemotherapy for metastatic breast cancer. J Clin Oncol 1996; 14:2197. 2.Falkson, G, Gelman, RS, Leone, L, Falkson CI. Survival of premenopausal women with metastatic breast cancer. Long-term follow-up of Eastern Cooperative Group and Cancer and Leukemia Group B studies. Cancer 1990; 66:1621.Falkson, G, Gelman, RS, Leone, L, Falkson CI. Survival of premenopausal women with metastatic breast cancer. Long-term follow-up of Eastern Cooperative Group and Cancer and Leukemia Group B studies. Cancer 1990; 66:1621.