The primary treatment of metastatic breast cancer is chemotherapy and radiotherapy, while surgery is reserved for treating local complications associated with the tumour. The survival in this group of patients has increased with the use of new chemotherapy and biological agents. A series of retrospective studies have recently appeared which show an increase in the survival of patients with metastatic breast cancer when surgery has been performed on the primary tumour. All these studies led us to the idea that there could be a group of patients with metastatic cancer whose survival improves if we add surgery to the chemo- and radiotherapy. The idea that local treatment may influence survival in breast cancer patients can have implications in the future multidisciplinary management of these patients.