Choice of maintenance chemotherapy regimens for breast cancer There is no evidence that breast cancer is a curable disease. Therefore, we are looking for drugs or regimens that are less toxic and easier to use for maintenance treatment. In breast cancer maintenance chemotherapy studies, a clinical trial from Korea using combination chemotherapy for maintenance treatment was positive. Similarly, oral capecitabine for maintenance therapy has been shown to have better disease control with long-term single-agent capecitabine maintenance therapy based on numerous evidence-based medical evidence both domestically and internationally. In China, about 20% of patients can be treated with capecitabine for 2 years as maintenance therapy. So, is there no place for two drugs in combination with chemotherapy? Actually, no. Sometimes in clinical practice, patients with younger age, more severe disease symptoms, higher tumor load, and symptoms of visceral metastasis may have value for maintenance therapy with combination chemotherapy. Most patients with slower disease progression and milder symptoms can be treated with capecitabine for maintenance. Comprehensive multidisciplinary treatment is required throughout the management of advanced breast cancer, i.e., from the time of diagnosis of recurrent metastases to the patient’s death. Surgery and radiotherapy are local treatments. Chemotherapy, endocrine therapy, molecular targeted therapy and other drug treatments are systemic treatments. In terms of local treatment, indications for radiotherapy include patients with pain caused by bone metastases, which can be relieved by radiotherapy; patients with possible bone metastases, which can lead to bone marrow compression and pathological fractures if radiotherapy is not used. Surgery is not valuable for patients with advanced breast cancer in general. However, a phase III clinical study from India at the San Antonio meeting last year showed that surgery is still of some value for patients with bone metastases only; it is of little value if accompanied by other visceral metastases such as lung and liver metastases. If spinal cord compression occurs, local surgical treatment may also relieve spinal cord compression. From the perspective of maintenance treatment, endocrine therapy is generally safer. For hormone receptor-positive patients, endocrine therapy is definitely the best maintenance treatment option. For HER-2-positive patients, long-term treatment with Herceptin has fewer toxic side effects and is suitable for maintenance therapy. For maintenance chemotherapy, we choose oral, easy-to-use drugs such as capecitabine. Capecitabine is currently the only oral chemotherapy drug approved for the treatment of advanced breast cancer in China. Overseas also approved oral vincristine for breast cancer, but not approved in China. So for breast cancer patients in China, if chemotherapy drugs are chosen as maintenance treatment, then single agent capecitabine treatment is the best choice.