for those with metastatic brst cancer deciding on whether to remove primary tumor
 

the latest:
Nat Clin Pract Oncol. 2007 Jan;4(1):14-5.
Improved survival in metastatic breast cancer following total excision of the primary tumor.

Morrow M.
M Morrow is the G Willing Pepper Chair in Cancer Research and Chairperson of the Department of Surgery at Fox Chase Cancer Center and Professor of Surgery at Temple University, Philadelphia, PA, USA.
PMID: 17183351 [PubMed - in process]

No abstract listed yet

The abstract is now available on Pubmed at:
http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

The study results indicate that the benefit of primary excision in metastatic breast cancer is only apparent when the only mets are bone mets.

I remember that a few years ago some oncs were hesitant to excise (not only because they thought it would not change the outcome as noted in the study) but also due to the observation that while primary tumors initiate local growth factors they also appear to generate antiangiogenesis agents acting remotely whose effect may be to slow the spread of mets.
I don't know if this theory has been confirmed later on.