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Breast cancer is one of the common malignant tumors in the world. About 6% of the patients are de novo stage Ⅳ breast cancer, which is incurable. Traditionally, the role of surgery has been confined to relieving symptoms, improving quality of life and reducing tumor load. Nowadays, a multidisciplinary team is a prerequisite for optimal management, and patients with oligometastatic lesion always live for a long time. R0 resection of the primary and metastatic foci can extend the time of progression-free survival (PFS), which may bring survival benefits. Therefore, whether to perform surgery has become a hot clinical issue. This article deeply discussed extensively the surgical value in de novo stage Ⅳ breast cancer patients.