The use of chemotherapy in metastatic breast cancer.

Recurrent breast cancer is incurable. Chemotherapeutic agents will be used in most patients with metastatic disease at some time during their course. There is little evidence that such agents prolong survival, and their toxicities are not inconsiderable. The focus of treatment should be on the palliation of symptoms. Single-agent regimens should not be assumed to be less effective than combinations, particularly as salvage therapies. Some new approaches to the management of metastatic disease are explored.