In general, except for some elderly or slow progressing hormone sensitive patients who can choose endocrine therapy alone, combination chemotherapy or new drug chemotherapy alone is the main means. Hirudar is often the first choice of physicians and patients because of its efficacy, convenience and safety, and gemcitabine is also approved by FDA as the first-line treatment for progressive breast cancer. However, the majority of patients with advanced breast cancer are treated with anthracyclines and paclitaxel, and they are not tolerant to subsequent chemotherapy and prefer to receive effective, low-toxicity and long-term treatment. In addition, more than half of the breast cancer patients are hormone-dependent. Currently, patients with advanced breast cancer who have been effectively treated with endocrine therapy are strongly resistant to chemotherapy once they progress; likewise, when multiple chemotherapy regimens are not effective for a patient with advanced breast cancer, clinicians have difficulty in accepting a switch to endocrine therapy. The timing and technique of endocrine therapy in advanced breast cancer patients is very critical nowadays, because the achievements of modern medicine have been fully demonstrated in the improvement of survival of breast cancer patients, and only patients who have applied endocrine therapy rationally will have more long-term survival and higher quality of life. Clinical trials have reported that 5 years of triamcinolone therapy can increase the 10-year survival rate of lymph node-negative hormone-dependent breast cancer patients by 5.6% and reduce the 10-year local recurrence rate by 14.9%; and increase the 10-year survival rate of lymph node-positive hormone-dependent breast cancer patients by 10.9% and reduce the 10-year local recurrence rate by 15.5%. local recurrence rate by 15.2%. Therefore, the first choice of endocrine therapy for elderly patients with steroid hormone receptor-positive (i.e. hormone-dependent) and recurrent metastatic breast cancer outside the internal organs (e.g. bones, skin and soft tissues) has been accepted by most clinicians, especially after the efficacy of the new generation of aromatase inhibitors (AIs) has been proven, such as letrozole and anastrozole, medical oncologists should have sufficient confidence to choose Endocrine therapy should be chosen with sufficient confidence as the main treatment. However, it is not uncommon that patients are strongly recommended to receive strong combination chemotherapy or local radiation therapy, and many patients are often troubled by sequelae or disabilities brought by overtreatment even though their tumors are under control. For young and viscerally recurrent metastatic breast cancer patients with positive steroid hormone receptors (i.e. hormone-dependent), chemotherapy should be the first choice, and combination chemotherapy should be the main treatment. It is generally believed that the efficacy of combination chemotherapy is better than that of monotherapy, with an efficiency rate of 45%-80%, CR rate of 5%-25%, median remission of 5-13 months, and median survival of 15-33 months for effective cases as first-line treatment for MBC. However, these patients still need reasonable multidisciplinary comprehensive treatment to prolong their survival and improve their quality of life to achieve the real purpose of treatment. Therefore, clinicians should look for ways to consolidate the efficacy of treatment after the patients have achieved the results, according to the patients’ own condition, which is suitable for continuous treatment. As 30%-40% of breast cancer patients are steroid hormone receptor negative, there are some advanced breast cancer patients who cannot tolerate chemotherapy, and these patients have received all the potentially effective chemotherapy drugs or regimens, and their general condition is relatively poor. The patient is often at the end of his or her rope and may wish to try endocrine therapy. In particular, it is important to review the patient’s steroid hormone receptor results for confidence. The authors observed that even in the medical oncology departments of provincial hospitals, 1/4 of the patients did not have accurate receptor status results during chemotherapy; 1/3 of the patients had immunohistochemistry results for receptor status from primary care hospitals without verification; and 1/3 of the patients from primary care hospitals had immunohistochemistry results for receptor status that were verified to be incorrect. The uncertainty of immunohistochemistry results may deprive some patients who should have benefited from adjuvant therapy of the opportunity for long-term survival. Therefore, for patients with relatively long tumor-free survival, endocrine therapy should be pursued, keeping in mind the heterogeneity of the tumor and the fact that current immunohistochemical approaches to receptor status do not result in 100% effectiveness in positive patients and 100% ineffectiveness in receptor-negative patients. The ASCO Technology Assessment report states that in postmenopausal, hormone receptor-positive breast cancer patients, appropriate adjuvant endocrine therapy should include aromatase inhibitors, either at the outset or in sequence with tamoxifen. Of course, both physicians and patients must fully evaluate the benefits and risks of each treatment option to determine the final treatment plan. Tamoxifen is no longer the gold standard and aromatase inhibitors are recommended for the adjuvant treatment of postmenopausal, endocrine-sensitive breast cancer: 1) 5 years of aromatase inhibitors alone (anastrozole and letrozole are recommended); 2) 2-3 years of tamoxifen followed by an aromatase inhibitor (exemestane and anastrozole are recommended) to complete a total of 5 years of treatment; 3) 5 years of tamoxifen followed by aromatase inhibitors (ezetimibe and anastrozole); and 4) 5 years of tamoxifen followed by aromatase inhibitors. Continue with an aromatase inhibitor (letrozole is recommended). Tamoxifen alone may be more appropriate for those patients with low risk and musculoskeletal and/or cardiovascular risk. However, there is no corresponding long-term follow-up information on the long-term benefits and safety of aromatase inhibitors. The incidence of adverse reactions is now known to be much lower with aromatase inhibitors than with tamoxifen. Another unspecified issue is whether chemotherapy and aromatase inhibitors can be used together. Most of the panelists favored chemotherapy followed by aromatase inhibitors, but this view is not supported by direct evidence. The incidence of breast cancer is increasing every year, but the mortality rate is gradually decreasing. This is due to improvements in the early diagnosis and treatment of breast cancer. An important trend in the treatment of breast cancer is the use of more targeted therapies that minimize acute and long-term toxicities without compromising treatment outcomes.