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There remains a number of unmet clinical needs in patients with breast cancer that research and development aims to address. More sensitive and specific indicators of prognosis are required to identify those patients at greatest risk for disease progression. A number of biological markers including the cyclins, circulating epithelial cells, and components of the urokinase plasminogen system have been shown to correlate with patient outcome. Genomic analysis also has the potential to predict patient response to specific agents, thus ensuring patients derive the maximum benefit from the treatment they receive. Patients who require treatment are often exposed to the undesirable toxic effects that are associated with some treatments. Liposomal and nanoparticle formulations of currently available agents have been shown to be at least as effective as their parent compounds but with improved safety and tolerability profiles. Studies into patient quality of life during therapy have highlighted the importance of early administration of an erythropoietic agent to treat chemotherapy-induced anemia. Further research in breast cancer should further optimize the treatment patients receive ensuring that patients not only live longer but also have quality survival.