New strategies for managing metastatic breast cancer.

In 1999, metastatic breast cancer claimed the lives of almost 45,000 women. For the vast majority of patients, metastatic breast cancer is an incurable disease with a median survival of only 2 to 3 years after diagnosis. The major goal of therapy is palliation. New endocrine agents developed during the last several years provide a greater opportunity for response in receptor-positive patients. New chemotherapeutic options have led to the reemergence of single-agent therapy as an effective palliative approach. Clinical trials remain the mainstay of cutting-edge therapy for metastatic breast cancer and should always be considered, if available. This review will focus on major issues in the treatment of metastatic breast cancer, including new endocrine and chemotherapeutic agents and a suggested strategy for patient management.