Advances in molecular biology and cancer genetics are translating into more focused cancer therapies where genetic analysis of cancer, in addition to histopathology, is guiding therapy. What started with hormone therapy selection in breast cancer by oestrogen receptor quantification has evolved into similar treatment target assessments being routinely required for colorectal and lung cancers, melanoma and lymphoma. 

Similar changes are occurring in the area of cancer genetics, for example, a woman’s risk of developing breast and/or ovarian cancer is greatly increased if she inherits a deleterious BRCA1 or BRCA2 mutation. It is clear that in the coming decade the complexity of treatment planning for our patients will increase substantially through growing recognition of these markers and their impact on diagnosis, treatment choices and prognosis.

This development of personalised medicine has predominately focused on cancer therapy. In parallel there is a growing movement of personalised support. In Lisbon, in November 2011, the first consensus conference on Advanced Breast Cancer (ABC1) was held. This meeting highlighted the needs of patients with advanced as opposed to early stage disease. Traditionally patients with metastatic breast cancer were felt to have a poor outlook. Now, 10% of these patients will still be living 10 years after relapse. The meeting was unique in that the keynote address was by a cancer advocate/survivor, who highlighted the personalised needs of patients living with breast cancer and the role of the Metastatic Breast Cancer Network (www.advancedbreastcancercommunity.org) dealing with the crisis, acceptance, adaptation and stability that such a diagnosis brings. 

These and other advocacy groups have also emphasised the need for more equitable resourcing for patients with advanced as opposed to early stage breast cancer. METAvivor Research and Support (www.metavivor.org) have launched a '30% for 30%' campaign for metastatic breast cancer patients. The concept is simple: As 30% of patients with breast cancer will develop metastatic disease, 30% of support and research funding should be directed towards them. 

An evaluation of the needs of patients living with metastatic breast cancer in Ireland would be timely and beneficial, and would facilitate the evolution of holistic personalised cancer care.