Treatment for advanced MBC has moved away from ablative surgical procedures such as orchidectomy and adrenalectomy to a variety of endocrine and non-endocrine systemic therapies. Tamoxifen was used extensively to treat advanced or metastatic MBC (mMBC) but has partly been superseded by more complex regimens derived from successful trials in FBC. Because aromatase inhibitors do not abolish estrogen synthesis from the testes, they have to be used in combination with GnRHa in order to improve outcome. In a small series of mMBC treated with fulvestrant, CR/PR occurred in 71%. The cyclin-dependent kinase 4/6 inhibitors palbociclib, ribociclib and abemaciclib have been used in combination with fulvestrant or alone with some limited success. The addition of Inavolisib to palbociclib has shown promising results in mMBC cases with PIKCA-mutated ER. Eribulin treatment resulted in CR in 2/14 mMBC cases. Everolimus in combination with exemestane or goserelin was less successful with static disease in 3 out of 4 cases.