The role of chemotherapy and targeted agents in patients with metastatic breast cancer.

Metastatic breast cancer has always been a challenging disease to treat, with cytotoxic chemotherapy often being deemed a merely palliative treatment that is given to relieve cancer-related symptoms. However with the introduction of more effective systemic therapies over the last two decades, recently we have witnessed substantial improvements in clinical outcomes such that many patients now live with metastatic secondary breast cancer for many years. Various different cytotoxics are used in clinical practice, and targeted biological therapeutics have an increasing role to play in the management of different breast cancer subtypes. The appropriate use of these different systemic therapeutics has been one of the principal reasons for the continued improvement in clinical outcomes for women with advanced breast cancer, including a probable substantial impact on overall survival.