Every oncologist has a dream – doing more with less toxicity. Targeted therapies seem to be the key for an oncologist’s dreams by defining subgroups of those patients who benefit more from a specific treatment and those who do not. For a few years now, targeted therapies have played a major role in the treatment of primary as well as metastatic breast cancer. In this article, we describe targeted therapies that already play an important role in clinical decisions in the treatment of metastatic as well as primary breast cancer. The humanised monoclonal antibody trastuzumab is a very effective agent in primary and metastatic breast cancer, but only for those patients whose tumours are overexpressing HER2/neu. Bevacizumab is an antibody directed against vascular epidermal growth factor ligand A which plays a role in angiogenesis. Up to now there is no predictive factor known for this treatment. Furthermore, we would like to give an impression of new agents and strategies under investigation like tyrosine kinase inhibitors and other small molecules.