The oncological advances of the past two decades havs enable individualized therapy for breast cancer. Breast cancers can now be characterized not only at the phenotype level by conventional immunohistochemistry but they can also be classified genotypically into intrinsic subtypes with differing prognoses and therapeutic responses on the basis of molecular genetic analyses. In clinical routine the various different subtypes are represented in a surrogate classification by means of immunohistochemistry. For therapeutic decision making, especially for luminal carcinomas, multigene expression analyses can be employed. In the context of personalized therapy more and more patients can be treated with neoadjuvant and targeted substances. In the present contribution the latest findings in systemic therapy for breast cancer in the adjuvant and metastatic situations are discussed.