{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T04:11:24Z","timestamp":1778731884528,"version":"3.51.4"},"reference-count":23,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec id=\"ab-soi260005-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Management of de novo metastatic breast cancer (dnMBC) often focuses on palliation. As such, the potential survival benefit of surgery or ablative therapy remains unclear, particularly for those with oligometastatic disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi260005-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association of surgical and\/or locally ablative treatment of the primary and\/or metastatic sites with overall survival (OS) in patients with single-site oligometastatic dnMBC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi260005-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This was a retrospective cohort study using the National Cancer Database. Patients diagnosed with oligometastatic, single-site (ie, brain, bone, liver, or lung) dnMBC receiving systemic therapy were selected from the National Cancer Database (2010-2020). Study groups included no locally ablative therapy\/surgery (NLT), primary breast tumor resection only (BR), metastatic site ablative therapy only (MT), and both therapies (BR+MT). Logistic regression identified factors associated with treatment strategy. Multivariable modeling was used to estimate the association of treatment with OS. Data were analyzed from August 2024 to September 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi260005-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>NLT, BR, MT, or BR+MT therapies for oligometastatic, single-site dnMBC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi260005-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary outcome measure was OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi260005-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 22\u202f433 patients (median [IQR] age, 61 [50-70] years; 22\u202f126 female biological sex at birth [98.6%]; median [IQR] follow-up, 61.5 [60.7-62.5] months), bone-only metastases were most common in 15\u202f441 (68.8%). Locally ablative therapies were uncommon (BR+MT, 1438 [6.4%]; MT, 2381 [10.6%]; BR, 3435 [15.3%] vs NLT, 15\u202f179 [67.7%]). Older age (&amp;amp;gt;70 years, odds ratio [OR], 2.49; 95% CI, 2.24-2.76 vs &amp;amp;lt;50 years [reference]) and higher comorbidity score (&amp;amp;gt;2, OR, 1.36; 95% CI, 1.16-1.60 vs 0 [reference]) were associated with NLT. Compared with NLT, BR (hazard ratio [HR], 0.62; 95% CI, 0.58-0.67) and BR+MT (HR, 0.60; 95% CI, 0.54-0.67) were associated with improved survival, but OS was worse for MT (HR, 1.22; 95% CI, 1.14-1.31).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi260005-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Results of this cohort study suggest that few patients with single-site dnMBC undergo surgical\/ablative therapy, although BR+MT and BR only were associated with improved OS. However, if invasive interventions are considered for patients with single-site dnMBC, resection of the breast primary may be beneficial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamasurg.2026.0098","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T16:30:42Z","timestamp":1772641842000},"page":"468","source":"Crossref","is-referenced-by-count":1,"title":["Locally Ablative Therapies in Oligometastatic Breast Cancer"],"prefix":"10.1001","volume":"161","author":[{"given":"Tori C.","family":"Nierenberg","sequence":"first","affiliation":[{"name":"Department of Surgery, Duke University Medical Center, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha M.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Biostatistics & Bioinformatics, Duke University, Durham, North Carolina"},{"name":"Biostatistics Shared Resource, Duke Cancer Institute, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Halliday","sequence":"additional","affiliation":[{"name":"Department of Surgery, Duke University Medical Center, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Astrid Botty","family":"van den Bruele","sequence":"additional","affiliation":[{"name":"Department of Surgery, Duke University Medical Center, Durham, North Carolina"},{"name":"Duke Cancer Institute, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ton","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Duke University Medical Center, Durham, North Carolina"},{"name":"Duke Cancer Institute, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura H.","family":"Rosenberger","sequence":"additional","affiliation":[{"name":"Department of Surgery, Duke University Medical Center, Durham, North Carolina"},{"name":"Duke Cancer Institute, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghan R.","family":"Flanagan","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Washington, Seattle"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gayle A.","family":"DiLalla","sequence":"additional","affiliation":[{"name":"Department of Surgery, Duke University Medical Center, Durham, North Carolina"},{"name":"Duke Cancer Institute, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. Shelley","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Duke University Medical Center, Durham, North Carolina"},{"name":"Duke Cancer Institute, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer K.","family":"Plichta","sequence":"additional","affiliation":[{"name":"Department of Surgery, Duke University Medical Center, Durham, North Carolina"},{"name":"Duke Cancer Institute, Durham, North Carolina"},{"name":"Department of Population Health Sciences, Duke University Medical Center, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","reference":[{"issue":"4","key":"soi260005r2","doi-asserted-by":"publisher","first-page":"452","DOI":"10.6004\/jnccn.2020.0016","article-title":"Breast cancer, version 3.2020, NCCN clinical practice guidelines in oncology.","volume":"18","author":"Gradishar","year":"2020","journal-title":"J Natl Compr Canc Netw"},{"issue":"5","key":"soi260005r3","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1001\/jamasurg.2015.4539","article-title":"Initial surgery and survival in stage IV breast cancer in the US, 1988-2011.","volume":"151","author":"Thomas","year":"2016","journal-title":"JAMA Surg"},{"key":"soi260005r4","doi-asserted-by":"publisher","DOI":"10.1177\/1179554920942440","article-title":"Role of locoregional treatment in de novo stage IV breast cancer.","volume":"14","author":"Lee","year":"2020","journal-title":"Clin Med Insights Oncol"},{"issue":"2","key":"soi260005r5","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1245\/s10434-018-6831-9","article-title":"Survival Impact of locoregional treatment of the primary tumor in de novo metastatic breast cancers in a large multicentric cohort study: a propensity score-matched analysis.","volume":"26","author":"Pons-Tostivint","year":"2019","journal-title":"Ann Surg Oncol"},{"issue":"1","key":"soi260005r6","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.amjsurg.2021.07.018","article-title":"Metastatic breast cancer: who benefits from surgery?","volume":"223","author":"Marks","year":"2022","journal-title":"Am J Surg"},{"issue":"9","key":"soi260005r7","doi-asserted-by":"publisher","first-page":"5048","DOI":"10.1245\/s10434-021-09621-8","article-title":"The effect of primary surgery in patients with de novo stage IV breast cancer with bone metastasis only (protocol BOMET MF 14-01): a multicenter, prospective registry study.","volume":"28","author":"Soran","year":"2021","journal-title":"Ann Surg Oncol"},{"issue":"6","key":"soi260005r8","doi-asserted-by":"publisher","first-page":"742","DOI":"10.1016\/j.jamcollsurg.2021.08.686","article-title":"Primary surgery with systemic therapy in patients with de novo stage IV breast cancer: 10-year follow-up; 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