Management of patients with metastatic breast cancer (MBC) is changing with the development of promising novel therapies such as eribulin. Effective patient management can be facilitated through a multidisciplinary team approach, taking into consideration multiple factors including guidelines and, from a UK perspective, national policies dictated by government. This article provides an overview of current practice in the management of patients with MBC and how it can be improved through wider considerations including treatment goals, personalised therapy and chemotherapeutic sequencing regimens. Specialist nurse support is an important part of caring for patients with MBC. In addition to helping patients to consider treatment options and managing palliative care in late disease, nurses offer vital psychological support to patients and their families or carers. The lack of metastatic breast cancer nurses requires urgent attention if the aims of national policy are to be met.