初诊Ⅳ期乳腺癌的发病率约占新发乳腺癌的3%~10%。作为一种恶性转移性肿瘤，目前尚无完全治愈的方法。一些研究结果提示初诊Ⅳ期乳腺癌患者无论是临床病理特征或是生存预后都与复发转移性Ⅳ期乳腺癌患者不尽相同。Ⅳ期乳腺癌的传统治疗主要为全身治疗，旨在减轻症状、延缓疾病进展、改善患者生活质量。近年来关于原发病灶切除术是否能改善初诊Ⅳ期乳腺癌患者预后这一问题存在巨大争议。为探讨这一问题，需要总结初诊Ⅳ期乳腺癌患者切除原发病灶的回顾性及前瞻性研究并分析影响患者手术获益的相关因素。而临床医生在实际工作中应结合不同患者实际情况，综合考虑个体化治疗方案。

The incidence of de novo stage IV breast cancer accounts for about 3%-10% of newly diagnosed breast cancer cases. As a malignant metastatic tumor, de novo stage IV breast cancer is incurable. Several studies suggest that the clinicopathologic features and survival prognosis of patients with de novo stage IV breast cancer are different from those of patients with recurrent metastatic breast cancer. The traditional treatment for stage IV breast cancer is mainly systemic therapy, aiming to alleviate symptoms, delay disease progression, and improve the quality of life of patients. In recent years, there has been great controversy over whether resection of the primary lesion can improve the prognosis of patients with de novo stage IV breast cancer. To approach this issue, it is necessary to summarize the retrospective and prospective studies of resection of primary lesions in patients with de novo stage IV breast cancer and to analyze the relevant factors affecting the benefit of surgery for patients. Therefore, clinicians should, based on the actual situation of different patients, comprehensively consider individualized treatment plan in the actual clinical work.