Patients with metastatic breast cancer with chemotherapy-sensitive disease, good performance status, and few sites of metastatic disease are the best candidates for high-dose chemotherapy and autologous stem cell reinfusion. Even in this selected subset of patients with metastatic breast cancer, at best 30% to 40% will maintain a complete remission beyond 2 years. In the high-risk adjuvant setting, high-dose chemotherapy appears efficacious; however, results from ongoing randomized prospective trials will not be available for several years.