We report a long-term survival case of metastatic breast cancer treated with trastuzumab and paclitaxel. The patient was a 64-year-old female. She underwent right quadrantectomy with axillary lymphadenectomy for advanced breast cancer. Histological examination showed papillotubular carcinoma, f, t2, n1(6/14), ER(-), PgR(-), HER2(3+). CMF and radiation were performed as adjuvant therapy. One year after the operation she was diagnosed to have liver metastasis and initiated trastuzumab treatment. Paclitaxel was also intermittently administered when the tumor marker was elevated. Four years after the operation, she experienced obstructive jaundice and was diagnosed as hepatic portal region metastasis. Obstructive jaundice was promptly alleviated after receiving trastuzumab and vinorelbin. No adverse events were reported over sixty-eight months of trastuzumab treatment. Long-term trastuzumab and intermittent chemotherapy would be one of the optimal treatments for HER2-positive breast cancer.