Advance care planning in metastatic breast cancer.

End-of-life care requires improvement. For a good death, patients consider five factors important: managing physical symptoms, avoiding a useless prolongation of dying, having good self-esteem, relieving burdens on the family, and deepening ties with loved ones. Four out of those 5 are accomplished by the implementation of advance care planning (ACP). ACP is not simply a formal writing of a patient's preferences about end-of-life treatment, but it is a process of communication between a patient, their family and care providers. There are few studies on ACP for patients with metastatic breast cancer. However, data on seriously ill patients support ACP's favorable effects on end of life care outcomes for not only patients, but family members and care providers as well. The observed keys to success for ACP were trained facilitators, education of the medical staff, inclusion of family and surrogate members, and a system to support ACP. ACP should be regarded as a standard of care to improve the quality of life of patients with metastatic breast cancer.