Breast cancer patients are most worried about the recurrence and metastasis of the disease, but recurrence and metastasis are indeed a problem that some patients have to face. The treatment of recurrent and metastatic breast cancer is more complicated and requires comprehensive treatment, precise treatment and maintenance treatment. Breast cancer is a group of diseases which can be divided into many categories, and the treatment strategies for different types of breast cancer are completely different. The site of recurrent metastasis, time of onset, patient’s age and previous treatment plan are all aspects to be considered in the design of treatment plan after recurrent metastasis. This is a middle-aged woman who has been operated for 5 years and has been doing well with regular medications during these 5 years. At the end of the 5-year period, she felt pain in her lower back, and after the review, she was considered to have bone metastasis in her lumbar spine. 2 lesions of about 1.5 cm were found in her liver during the routine review. The efficacy of endocrine therapy depends on the expression of estrogen and progesterone receptors in the lesion. To prevent lumbar fracture, the patient underwent lumbar spine fixation surgery, and the metastatic lesion removed by surgery did not have high estrogen and progesterone receptor expression, which made the decision of endocrine therapy difficult for the doctor. I am glad that I advised the patient to do this test and that the patient trusted me enough to accept it. The test results showed that this was a receptor-negative, Her2-positive breast cancer, a type that is not sensitive to endocrine therapy but more sensitive to targeted therapy and chemotherapy against Her2. Thus we opted for chemotherapy combined with trastuzumab, and after 6 cycles of treatment, the liver lesion was almost completely gone, a first success! Next we will enter a relatively long-term maintenance treatment phase. From this case, we can see the cunningness of breast cancer, its phenotype will change after long-term treatment, which reminds us to detect the “changing face” of breast cancer, to find it, identify it and defeat it by re-biopsy of the lesion!