The pace of research in breast cancer has picked up significantly in recent years, due to both increased public awareness and improved technology. The availability of many new agents in an already crowded field has resulted in several challenges (both practical and conceptual) for the research community. This report suggests that the "business-as-usual" approach to drug development has important limitations rendering it inadequate to the current research climate. Future drug development, in the form of biologically targeted therapies, offers the best hope for defeating this disease.