OBJECTIVES: To understand unmet needs in metastatic breast cancer (mBC), a survey was conducted as part of a medical chart review study. METHODS: An on-line physician survey was developed for oncologists and medical hematologists treating mBC patients. Questions fell into five categories: physician characteristics, mBC patient quality of life (QoL), satisfaction with existing treatments, provider/patient interaction, side-effects with current treatments. RESULTS:  103 physicians completed the survey across the US, with 70% of the physicians being office-based. Physician treated an average of 80 ER+ HER2- mBC patients in the past 6 months. Hormonal treatment is most frequently used in first-line mBC (63.6% of cases) and also considered in second-line along with exemestane/everolimus. In third-line, treatments include bevacizumab, radiation and clinical trials. Chemotherapy is used across all lines.  Physicians perceive that living with mBC affects multiple aspects of patients’ lives, including QoL, physical wellbeing and emotional functioning. While 82% of physicians agree that it is important to have an equal patient-physician relationship for decision making, 94% find that patients agree with the treatments suggested to them. A treatment is selected so that patients can stay on chosen first treatment for as long as possible (87%) and can enjoy the highest QoL (91%). The most important treatment goal for first-line treatment is to prolong life (58.3%), or maintain/improve QoL (22.3%). The delay of bone metastases is also deemed important. Progression-free survival (PFS) is perceived as potentially increasing overall survival (39.8%) and as providing the opportunity to improve QoL (20.4%). While physicians are generally satisfied with current treatment options for mBC, 58% agree that there is a need for new treatments. CONCLUSIONS: Physicians are aware of the burden, value equal decision-making, select treatments to achieve the main first line treatment goals and see room for new treatments.