OBJECTIVES: Health technology assessment (HTA) is rapidly developing in CEE countries as new technologies are difficult to finance with scare resources. Researchers often struggle with limited local epidemiologic and cost data. Therefore transferability of resource utilization from one to other markets is becoming an interesting topic. Late 2009 we conducted a study of advanced breast cancer in four CEE markets (Poland, Hungary, Slovak and Czech Republics).  The project aimed to assess treatment sequence and resource used. METHODS: A common questionnaire was distributed to oncologists managing about 30 % of all oncology patients. The assessed periods of advanced breast cancer were: a) treatment initiation; b) routine follow-up on active treatment; c) pre-progression follow-up; and d) progression period. Data were extracted from hospital information systems and patient´s charts retrospectively. Final results covered individual treatment/disease periods and total treatment course. RESULTS: Similar proportions of breast cancer patients precede to second-line treatment, we found differences in patients proceeding to third line treatment. In Czech about 67 % of treated completed 3 lines chemotherapy, in Poland it was about 30 %. In Czech and Slovakia taxane monotherapy represented the preferred first-line choice, Poland and Hungary favoured combination chemotherapy. We found differences across countries such as cancer care organization, guideline availability, number of oncologists. The above mentioned differences resulted in cost variations per patient from about 6 thousand USD (excluding chemotherapy) in Poland to 12 thousand USD in Hungary. Positions with highest relevance to cost differences were frequency and reimbursement of in-patient management and BS/palliative care. CONCLUSIONS: As cancer care organization, treatment algorithms and reimbursement for services differ, there is limited value in transferring cost data across CEE countries. The observed differences are especially relevant for cancer care where market access for new technologies might be un-equal in particular health care systems.