Low accrual and no further funding.

The purpose of this study is to determine benefits of surgery for the primary in patients with breast cancer stage IV in randomized controlled study.

Inclusion Criteria:

• Healthy breast cancer stage IV patients with resectable primary breast tumor.
• Resectable breast cancer stage IV patients who well response of visceral metastasis to systemic therapy and fit for surgery.

Exclusion Criteria:

• Breast cancer stage IV patients with local complication of primary breast tumor that require surgery for palliation such as uncontrolled bleeding,large and non-healing ulcer or intractable pain.
• Breast cancer stage IV patients with unresectable primary breast tumor or extensive chest wall disease.