Do you offer consolidative radiation for oligometastatic breast cancer?

I'd like to add a few additional considerations to the already excellent responses from our colleagues. Many of the trials cited actually address two related but distinct clinical questions, and the answer for HER2-positive disease specifically may diverge from the population-level results.

Trials of...

Not routinely, as prospective randomized trials have not shown any survival advantage.

No, I typically would not offer consolidative RT to either the primary or metastatic lesions in a patient with known stage IV breast cancer. There have been several cooperative group trials that have determined that most patients with stage IV breast cancer do not benefit from the primary being trea...