[Therapeutic aspects of advanced high risk breast cancer]

In the treatment of metastatic breast cancer patients, remission rates and survival are determined by prognostic criteria and not by the choice of treatment. It remains to be proven whether or not the intensification of chemotherapy leads to a higher complete remission rate and/or prolongs survival. Generally, patients derive benefit from achieving a "no change" status. Therefore, milder treatment regimens are preferred except in clinical trials. However, additional research is mandatory to analyze treatment results in clearly defined prognostic subgroups to determine if specific subgroups benefit with prolonged survival and/or improved quality of life. Aggressive treatment with severe side effects should only be administered in such studies or if milder treatment regimes are no longer effective. The aim of palliation has to be kept in mind.