High-dose chemotherapy with autologous stem cell support for breast cancer.

Breast cancer is a major public health issue, expected to affect one out of nine women over a lifetime. High-dose chemotherapy with autologous stem cell support is a current approach to the management of metastatic breast cancer and high-risk primary breast cancer. This review considers the effectiveness of this modality in the treatment of breast cancer in an effort to define its role in overall patient management. Current research directions, including technical advances aimed at reducing toxicity, are discussed. Finally, controversies regarding the role of third-party payers in the investigational process are considered.