lthough improvements have been made in outcomes for women with early-stage breast cancer, as many as one third of women will develop and, subsequently, die from metastatic breast cancer. Although the prognosis for metastatic breast cancer generally is poor, median survival time from diagnosis of secondary disease is about three years; therefore, survival is highly variable (Johnston, 2010). Some women have rapidly progressive disease, whereas others can live with metastatic disease for as many as 10–15 years (John -ston & Swanton, 2006). A diagnosis of metastatic breast cancer has a profound emotional impact (Beacham, Hill, Mc-Dermott, O’Brien, & Turner, 2005), with the majority of women considering the recurrence more distressing than the original diagnosis (Warren, 2010). Some of these women experience clinically significant levels of distress (Caplette-Gingras & Savard, 2008; Turner, Kelly, Swanson, Allison, & Wetzig, 2005). A wide variety of treatment options are available, including hormone ther-apy, chemotherapy, and new targeted therapies. These therapies are improving tumor response rates and, potentially, the survival of women with metastatic breast cancer (Geyer, Forster, & Lindquist, 2006; Miller, Wang, & Gralow, 2005). The care of women with metastatic disease usually involves a multidisciplinary team (MDT) of healthcare profession-als, including medical and radiation oncologists, breast care nurses (BCNs), and palliative care specialists (Amir, Scully, & Borrill, 2004). Although the ob -jective of the MDT is to provide optimal patient care, treatment and care may be fragmented.Women diagnosed with metastatic breast cancer have unique and pressing