For a patient with oligometastatic breast cancer that has completed adequate local therapy, would you consider ablating synchronous oligometastatic disease?

If the oligometastatic lesions are not longer PET avid after neoadjuvant chemotherapy, would you consider further treatment with local therapy or observe? Synchronous oligometastatic disease that responds to chemotherapy presents a challenge as compared to metachronous oligometastatic disease. NRG-BR002 protocol inclusion criteria requires that oligometastatic disease are seen within 60 days of registration on standard imaging. SABR-COMET excludes patients with upfront lesions that have completely responded to chemotherapy.