[Debbie L.]

Kat, welcome. We're glad you're out of lurkdom.

I think the jury is (alas) still out on this question of local surgery for de novo Stage IV diagnoses. There have been mixed results (small benefit vs. none) in studies of this question that have reported out so far. In addition, experts have critiqued the existing results, finding various faults in the study design(s), so it's hard to know the answer. Add to that the fact that you had such a good response to your first 6 treatments, which means most of the women in these studies are not exactly the same as you. There are studies ongoing that should eventually give us some better answers, but that doesn't help you now. The two largest, most recent studies that I'm aware of were not done in the US, and other treatment was not the same as would be done in the US, so US oncologists seem somewhat split on the answer to the question. Here's an article that is fairly balanced (presenting both sides of the argument): Any Role for Breast Surgery in Stage IV Disease? . (it's a MedPage article link -- I think you may have to register to see it, but it's free to do so)

As for radiation to the spine, I'm not familiar with doing that when there's no evidence of disease present. I thought radiation of bones was to decrease existing tumor burden, relieve pain, etc. Have others here had rads to bones when NED?

This would be a great time for a second opinion at an NCI-designated Comprehensive Cancer Center. Not only would it give you guidance now, but down the road it will give you peace of mind, knowing that you had as much information on the table as you could gather, in making this treatment decision.

Good luck, and keep us posted, okay?

Debbie Laxague