The treatment of advanced metastatic breast cancer can be an art. There are almost no standardized treatment options for advanced breast cancer, especially after the failure of first-line palliative treatment, thus requiring clinical medical experts to pool more wisdom, weigh the pros and cons, and choose the most appropriate treatment strategy. As most of the advanced stage patients are incurable, improving their quality of life and prolonging their survival time become the main treatment objectives. How to give the most reasonable and effective treatment to advanced patients is not so much a test of clinicians’ skills as it is a test of their souls, because they have to put more energy and care into it. Based on this, the ESO-MBC working group experts drafted twelve recommendations on the standardization of diagnosis and treatment of advanced metastatic breast cancer: 1. A multidisciplinary collaborative team including medical oncology, radiotherapy, surgery, imaging, palliative care, and psychosocial experts are needed to participate in the treatment. 2. Once diagnosed, patients should be given individualized psychological counseling to control their uncomfortable symptoms as soon as possible, while starting supportive treatment, which should be an important component of comprehensive treatment for patients with advanced disease. 3.After the diagnosis is confirmed and the condition is fully evaluated, a more realistic treatment objective should be discussed and the patient and family should be invited to participate in the development of all treatment plans. 4, Special emphasis is placed on the fact that some patients who collect and organize single lesions or regional recurrent metastases can achieve complete control and long-term survival. More aggressive multidisciplinary and comprehensive treatment should be given to this patient group, and scientific clinical trial studies should be advocated for them. 5. The following information should be collected: medical history, physical examination, blood biochemical examination, chest, abdomen and bone imaging. Tumor markers cannot be used as diagnostic criteria yet, but they can assist in evaluating the efficacy, especially for patients with unmeasurable lesions. The following factors should be taken into consideration in the development of treatment plan: sensitivity of endocrine therapy, HER2 status, menstrual status, disease-free survival, previous treatment and efficacy, tumor load (metastatic site and number), biological age of patients, coexisting disease, physical condition, the need for rapid tumor and symptom control, socio-economic and psychological factors, personal will of patients, and treatment conditions in the patient’s geographical area. 7. For hormone receptor-positive patients, endocrine therapy is preferred unless there is clear evidence of resistance to endocrine therapy. The reasonable first-line endocrine therapy for postmenopausal patients is aromatase inhibitor (AI) or tamoxifen, and for premenopausal patients, tamoxifen combined with ovarian function suppression or resection, unless tamoxifen is resistant. there is no standard drug selection scheme after failure of AI therapy. The use of endocrine therapy for maintenance after relief chemotherapy is inconclusive, but appears reasonable. Chemotherapy combined with simultaneous endocrine therapy should not be collected. 8. After failure of endocrine therapy, trastuzumab should be given to HER2-positive patients as early as possible. Endocrine therapy combined with trastuzumab therapy is still in the trial stage and is not yet the standard protocol. For patients with disease progression after trastuzumab treatment, treatment options are still under investigation. 9. Whether chemotherapy is combined or sequential must take into account the factors in Article 6, with special emphasis on obtaining efficacy and quality-of-life improvement as soon as possible. Overall survival is similar in most patients with sequential and combination regimens. The application time frame and number of regimens for each regimen should be individualized according to the patient’s own situation. 10.Patients are encouraged to actively participate in scientifically designed prospective, independent clinical trials, and trial treatment protocols must have a clear scientific basis, with priority given to evidence-based medical research findings. 11, medical practitioners and individuals should always weigh the costs and benefits of patient treatment, and patient health, survival and quality of life should always be the first factor to consider. 12. Formal or even informal quality-of-life assessments can provide useful information and should be encouraged, and this information should be integrated into treatment planning for timely implementation, termination, and change of treatment strategies.