PURPOSE Oligometastatic breast cancer (oligo-mBC) represents up to 40% of newly diagnosed metastatic breast cancers. The current standard of care in the United States is to treat metastatic breast cancer palliatively although optimal management of de novo oligo-mBC remains uncertain and practice patterns in the treatment of oligo-mBC vary. We present a survey of US medical oncologists regarding their management of de novo oligo-mBC. METHODS All ASCO members who participate in the ASCO Survey Pool (999) were sent an invitation e-mail between November 14, 2023, and January 2, 2024. The survey asked eight demographic questions, and four questions focused on treatment preferences, per receptor subtype—estrogen receptor–positive, human epidermal growth factor receptor 2–positive (HER2+), and triple-negative disease. RESULTS A total of 144 of 193 respondents met the criteria of medical oncologists who treat breast cancer. A total of 136 medical oncologists who treat breast cancer completed the survey. The majority of respondents recommend initial palliative systemic chemotherapy; however, if a patient shows a positive response to initial chemotherapy, a substantial amount of respondents (42%-54%) recommend ablative radiation of all residual lesions and 38%-52% recommend surgical resection of the primary tumor. The results varied by receptor subtype, with the highest percentage of respondents recommending curative-intent therapies in HER2+ disease, although these differences were not statistically significant. CONCLUSION Our results indicate varied practice patterns in the treatment of de novo oligo-mBC. A substantial number of medical oncologists recommend ablative radiation and surgical resection of the primary breast tumor. This highlights the need for clarity regarding practice guidelines in de novo oligo-mBC.
Odzer et al. (2026) studied this question.