Oligometastatic disease and remote stereotactic body ablative radiotherapy. Part II. Breast cancer

Metastatic breast cancer has historically been considered an incurable disease. Radiotherapy (RT) has traditionally been used only for the palliative treatment of symptoms caused by metastatic foci. However, in recent years, the concept of oligometastatic disease (OMD) has been introduced in oncological practice as a clinical scenario with the presence of a limited number of metastases (≤ 5) and lesions of a limited number of organs (≤ 3) against the background of a controlled primary tumor process. It has been suggested that in OMD, local-regional treatment of the primary tumor and antitumor therapy targeting foci of metastasis using surgery or RT may, in general, improve the outcomes of specific treatment. Recent studies have shown that not all patients with metastatic breast cancer have the same prognosis of the underlying disease. It is possible to select patients with good prognostic features, such as age less than 55 years, hormone receptor-positive, limited bone or liver metastases, tumor of low malignancy, satisfactory general condition, prolonged recurrence-free period after initial antitumor treatment (>12 months), and a good .response to systemic therapy. The presence of such prognostic features can ensure maximum efficacy from radical treatment of all tumor foci.This review is a continuation of a series of reviews on the current status of the role of remote stereotactic ablative radiotherapy of the body (RSABR) in OMD. The review will discuss the concept of oligometastases and will present the current information available in the open press on the use of RSABR in oligometastatic breast cancer.