The management of patients with advanced breast cancer is often complex and requires the involvement of the multidiscliplinary team. With the emergence of an increased number of targeted therapies in the past five years, the role of nurses is becoming even more important especially with regard to the management of associated treatment side effects in the outpatient setting. Whilst novel agents now commonly allow metastatic cancer patients to remain on treatment for years, patients often require close supervision and monitoring for potentially life threatening toxicities. Educated specialist nurses are the key to successful management of these advanced cancer patients, facilitating safe administration of targeted therapies and enabling the patient to maintain optimal quality of life.