[Therapeutic strategy in advanced breast carcinoma]

Breast cancer metastastic to sites beyond regional axillary lymph nodes represents a historically incurable condition despite the judicious use of various hormonal manipulations and surgical and radiotherapeutic interventions, and the application of active cytotoxic chemotherapeutic agents for hormone-refractory disease. The systemic management of patients with hormone refractory breast cancer is classically characterized by the thoughtful, stepwise administration of cytotoxic chemotherapeutic agents. At various junctures in the continuum of care, a patient/physician analysis of the potential risks and benefits of chemotherapy may lead to the decision to proceed with subsequent systemic therapy, to consider an investigational strategy like new active agents or high dose therapy, or to opt for supportive care alone.