Objective: To depict a clear and coherent picture of the overall course of palliative treatment in an unselected study cohort over the course of time. Methods: We compared therapy type and course of 242 women whose distant metastatic disease was diagnosed from 1990 to 2006 and who ultimately died of the disease. We divided the patients into two subgroups depending on the year of diagnosis of metastases (group A: 1998–2006 vs. group B: 1990–1997). Results: In both subgroups, there were no significant differences in the general type of treatment and the number of administered therapy lines (no systemic therapy: 12.9 vs.13.7%, p = 0.848; endocrine therapy only: 20.4 vs. 25.2%, p = 0.430; chemotherapy only: 18.4 vs.16.9%, p = 0.735; sequential combination regimen including endocrine therapy/chemotherapy/trastuzumab: 46.9 vs. 44.2%, p = 0.694; median: 2 lines). In the cases where chemotherapy was administered, there were no differences between the number of lines among older and younger patients (median: two lines; ≥70 years vs. <70 years: p = 0.269). The median metastatic disease-specific survival increased from 16 months in the period from 1990 to 1997, to 21 months in the period from 1998 to 2000 (p = 0.062). Conclusion: The number of patients who died from metastatic breast cancer without receiving any antineoplastic therapy was surprisingly high. The use of newer agents and regimens in the treatment of metastatic breast cancer was associated with an improved survival over time. Chemotherapy is a feasible option also among older patients.

Bergh J, Jonsson PE, Glimelius B, Nygren P: A systematic overview of chemotherapy effects in breast cancer. Acta Oncol 2001;40:253–281.
Chung CT, Carlson RW: Goals and objectives in the management of metastatic breast cancer. Oncologist 2003;8:514–520.
Ellis M, Hayes D, Lippman M: Treatment of metastatic breast cancer; in Harris J, Lippman M, Morrow M, Osborne K (eds): Diseases of the Breast. Philadelphia, Lippincott Williams & Wilkins, 2004, pp 1101–1159.
Esteva FJ, Valero V, Pusztai L, Boehnke-Michaud L, Buzdar AU, Hortobagyi GN: Chemotherapy of metastatic breast cancer: what to expect in 2001 and beyond. Oncologist 2001;6:133–146.
Gralow JR: Optimizing the treatment of metastatic breast cancer. Breast Cancer Res Treat 2005;89(suppl 1):S9–S15.
Nicolini A, Giardino R, Carpi A, Ferrari P, Anselmi L, Colosimo S, Conte M, Fini M, Giavaresi G, Berti P, Miccoli P: Metastatic breast cancer: an updating. Biomed Pharmacother 2006;60:548–556.
Wildiers H, Kunkler I, Biganzoli L, Fracheboud J, Vlastos G, Bernard-Marty C, Hurria A, Extermann M, Girre V, Brain E, Audisio RA, Bartelink H, Barton M, Giordano SH, Muss H, Aapro M: Management of breast cancer in elderly individuals: recommendations of the International Society of Geriatric Oncology. Lancet Oncol 2007;8:1101–1115.
Chia SK, Speers CH, D’Yachkova Y, Kang A, Malfair-Taylor S, Barnett J, Coldman A, Gelmon KA, O’Reilly SE, Olivotto IA: The impact of new chemotherapeutic and hormone agents on survival in a population-based cohort of women with metastatic breast cancer. Cancer 2007;110:973–979.
Andre F, Slimane K, Bachelot T, Dunant A, Namer M, Barrelier A, Kabbaj O, Spano JP, Marsiglia H, Rouzier R, Delaloge S, Spielmann M: Breast cancer with synchronous metastases: trends in survival during a 14-year period. J Clin Oncol 2004;22:3302–3308.
Fossati R, Confalonieri C, Torri V, Ghislandi E, Penna A, Pistotti V, Tinazzi A, Liberati A: Cytotoxic and hormonal treatment for metastatic breast cancer: a systematic review of published randomized trials involving 31,510 women. J Clin Oncol 1998;16:3439–3460.
Stockler M, Wilcken NR, Ghersi D, Simes RJ: Systematic reviews of chemotherapy and endocrine therapy in metastatic breast cancer. Cancer Treat Rev 2000;26:151–168.
Cardoso F, Di LA, Lohrisch C, Bernard C, Ferreira F, Piccart MJ: Second and subsequent lines of chemotherapy for metastatic breast cancer: what did we learn in the last two decades? Ann Oncol 2002;13:197–207.
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