Inclusion Criteria:

- Patients age ≥ 18 years

- Eastern Cooperative Oncology Group Performance Status is 0 -2

- Untreated synchronous metastasized invasive carcinoma of the breast with the primary
tumor in situ (bilateral synchronous metastasized breast cancer patients are
eligible)

- The primary tumor must be identified and may be any size, however, primary resection
with resection free margins must be possible

- Invasive adenocarcinoma of the breast on histological examination

- The metastatic site must be identified by radiological assessment(Computer Tomography
of the chest and the abdomen OR ultrasound and chest x ray for visceral metastases;
bone scan AND/OR computer tomography AND/OR magnetic resonance for bone metastases).
A biopsy is not necessary.

- Written informed consent must be obtained and documented prior to beginning any
protocol specific procedures and according to local regulatory requirements

- able to comply with the protocol requirements during the treatment and follow-up
period.

Exclusion Criteria:

- Patients in whom a R0 resection (microscopic free margins) is clinically questionable

- Inflammatory cancer

- Patients with a brain metastasis

- Patients who are not eligible for general anesthesia and operations

- Patients without metastatic breast cancer (patients with a tumor marker value (CEA,
CA15-3) above normal levels without the radiological proven evidence of metastases
are not eligible for the study)

- Patients with a second untreated malignancy

- Any previous malignancy treated with curative intent and the patient has not been
disease-free for 5 years - exceptions are: (a)carcinoma in situ of the cervix,
(b)squamous carcinoma of the skin, (c)basal cell carcinoma of the skin

- Patients with any recurrent cancer disease

- Pregnant or lactating women

- Patients are not allowed to be part of another local therapy trial