Treatment of advanced breast cancer: the good, the bad and the ugly.

Every year more than 1 million women are newly diagnosed withbreast cancer, and this figure will likely reach 1.5 millionwith the increased number of cases arising in developing countries[1]. Many of these patients will be offered adjuvant treatmentbased on consideration of disease responsiveness to specifictherapies [2], and almost half eventually will have local ordistant relapses.  Metastatic, or advanced, breast cancer is a chronic diseaserequiring specific strategies to control disease progressionand related symptoms. The treatment choice is often based onevidence obtained from trials designed to investigate therapy-relatedissues such as whether one treatment yields better responsesor longer time to progression. These trials frequently evaluatewhether a given treatment is effective in a selected group ofpatients, usually using measurable or evaluable disease to guidepatient selection and avoiding, for example, those with only