The past five years has seen an emergence of targeted therapies as a mainstay of breast cancer treatment. Accompanying these novel agents are treatment toxicities which are often different in etiology and pathogenesis to toxicities previously experienced with cytotoxic agents. Management of these new classes of side effects is often complex and requires close supervision of the patient by the oncology team. With the incidence of cancer rising, the ability of medical oncologists to manage these patients independently in the outpatient setting is becoming increasingly difficult. Specialist nurses can be educated and trained to manage these patients autonomously and effectively as a part of the medical oncology team.