First-Line Chemotherapy for Advanced Breast Cancer.

First-line chemotherapy for metastatic breast cancer has been the focus of ongoing controversy, a condition that partially reflects the imperfections of available therapy. It also partially reflects not only the imperfections in our ability to monitor response, but also the disagreements among clinicians over the goals of therapy. Each physician maintains a hierarchy of goals for the treatment of patients — prolongation of survival, palliation of symptoms, minimization of toxicity, and rarely, in a small fraction of patients, the potential for cure.