A systemic treatment regime is presented for the management of disseminated carcinoma of the breast based on the dominant site of metastasis. Additional factors, such as menopausal status and length of free interval are considered in management. Treatment is suggested depending on whether the dominant site of the metastasis is defined as favorable or unfavorable. Admittedly brain metastasis and inflammatory breast carcinoma are special unfavorable sites requiring special management. It is hoped that attention to the dominant site of metastasis will provide a more rational basis for management of disseminated carcinoma of the breast.
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