Metastatic disease of the breast and local recurrence of breast cancer

Breast cancer is a major health problem worldwide with over 1 million new cases diagnosed each year. The aim of treatment is to achieve good loco-regional control, provide appropriate adjuvant therapy and treat potential micro-metastasis. Early detection with breast screening and better treatment options have improved outcome. However approximately 40% of patients will suffer a recurrence and still 35–40% will eventually present with metastatic disease. Metastatic disease is incurable with the median survival being 2–3 years. Several therapies have been shown to maintain a good quality of life whilst prolonging survival. In certain sub-groups of breast cancer, that is, human epidermal growth factor receptor 2 (HER2)-positive cancer the advent of trastuzumab has improved survival rates. A multidisciplinary team approach is essential to obtain the diagnosis and plan the appropriate treatment. The diagnosis of metastatic disease brings distress to patients and their relatives and support should be available from palliative care teams.