The population of survivors living long-term with incurable breast cancer has grown rapidly, and clinicians may not be aware of how to manage the many unique issues and needs faced by this population.

The treatment landscape for breast cancer has shifted dramatically over the last several decades and, despite the increasing incidence of breast cancer, overall survival rates continue to improve.

The decision-making process for management of metastatic breast cancer should involve careful consideration of the available evidence for selection of optimal therapy and a detailed discussion with patients of the benefits and risks associated with all possible treatment strategies.

Advances in diagnosis and treatment have increased the survival of patients with advanced breast cancer; however, longevity is associated with an increased detection of brain metastases in these individuals.

There is a growing emphasis on individualizing surgical treatment based on patient and tumor specific factors.

The strategies for adjuvant radiation therapy have evolved over the years aiming to de-escalate the therapy in order to balance treatment efficacy with minimized adverse outcomes.

The treatment landscape of breast cancer is evolving constantly. The decision-making process of treatment selection should involve careful consideration of the available evidence and a detailed discussion of the associated benefits and risks with patients.

Clinicians can benefit greatly from understanding the technology involved in genomic and molecular testing and profiling assays and their interpretation. Clinicians should know what, when, and how to test and how to make subsequent informed, patient‐personalized treatment decisions.