Progress in the systemic therapy of breast cancer, especially in the adjuvant situation, based on systematically performed clinical trials, represents a paradigm for applied clinical research in general and in particular for oncology. This survey will present detailed indications for the evidence-based use of chemotherapy and hormone therapy in breast cancer, based on the relevant prognostic and predictive factors available. Drugs, both conventional and still under investigation, as well as therapeutic strategies will be reviewed with respect to their use in the adjuvant and the palliative situation. Explicit distinction will be made between standard therapies on the one side and expected new developments on the other side. Therapeutic details, general therapeutic guidelines as well as critical appraisals of recent developments such as high-dose chemotherapy or chemoprevention will be considered.