Summary

• There is great heterogeneity in both the presentation and prognosis of metastatic breast cancer.
• Multi-gene expression panels are being evaluated to determine which women with early stage breast cancer are more likely to develop metastatic disease.
• Decisions on whether or not to treat a patient with metastatic breast cancer and the aggressiveness of treatment must be individualised, based on patient prognosis, tumour characteristics, performance status, and the primary goals of treatment.
• Unlike stage I to III breast cancer, the primary goal of treatment in metastatic breast cancer is often to improve quality of life, with extending life a secondary goal.