الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Breast cancer is the most common neoplasm in women accounting for about 26% of all cancer cases diagnosed annually. It is over all the second leading cause of cancer death .However breast cancer is the leading cause of cancer death in women below 65 years.Of all breast cancer patients 3–10% has distant metastases at initial presentation. Median survival of these patients is in the range of 16–24 months and is determined by several factors, including number and site of metastatic lesions, and tumor characteristics such as hormone receptor and HER2neu status. The recommended primary treatment approach for women with metastatic breast cancer and an intact primary tumor is the use of systemic therapy, with local therapy for the primary tumor reserved for palliation of symptoms.During the last decades, the treatment of metastatic breast cancer has undergone considerable changes, with taxanes and third generation aromatase-inhibitors being introduced in the nineties of the previous century and, among others, trastuzumab and bevacizumab in the current decade.Systemic therapy is clearly the primary treatment with overt metastasis, over the past years several retrospective series have investigated the association of the survival in metastatic breast cancer patients with loco-regional control. Similarly, surgical resection of metastatic lesions and radiotherapy has a promising result.Aim: A combined retrospective and prospective study to evaluate the survival benefit of primary tumor resection by surgery in metastatic breast cancer patients.Patients and methods: A combined retrospective and prospective study including patients with metastatic breast cancer between (2010/2018) in General Surgery department, Mansoura University Hospital. Patients with metastatic breast cancer are selected by order from all breast cancer patients who was admitted to be treated in the General Surgery Department Mansoura University in 2010-2015 and followed up until 2018.patients are divided into two groups group A: patients who underwent surgery group B : patients who didn’t underwent surgery.Then we compare the survival of the two groups.Results: We found 5000 patients with breast cancer only 322 of them were found with metastatic breast cancer. Of the 322 patients, only 122 were with metastatic breast cancer as a first presentation. After studying, the files of 122 patients 42 of them were excluded from the study either for they were not fit for surgery, they refused treatment or they just lost follow up leaving us with 80 patients.After comparing the survival between the two groups there was no significant value with P value 0.890 and median survival, 23 months.Conclusion: According to the results of our study as the latest guidelines, the surgical interference in patients with metastatic breast cancer will not benefit nor harm them.