OBJECTIVES To identify current treatment patterns of care for patients with metastatic breast cancer (MBC), refractory to anthracyclines and taxanes, treated under the perspective of the Brazilian public health care system. METHODS A cross-sectional study of patients from 4 public hospitals in south and southeast region of Brazil. All patients ≥18 years diagnosed with MBC who had progressed following treatment with an anthracycline and a taxane between 2003 and 2006, with at least 4 months of survival after metastatics disease were included. Data was collected from their medical charts. RESULTS 217 patients with an average age of 52 years (25-80 years old) were included in the analysis. Among patients with HER2 testing (59%), 40% were HER-2 positive and among patients with hormone receptor testing (89%), 51% were hormone receptor positive. 85% of the patients had information regarding treatments received in their medical charts. The most frequent chemotherapy regimens prescribed following use of anthracycline and taxane ("first line") were capecitabine (52.7%), gemcitabine+cisplatin (17.4%), and tamoxifen (8.7%). Second line treatment was prescribed for 58% of patients: gemcitabine+cisplatin (23.4%), capecitabine (20.6%), vinorelbine (14.0%), tamoxifen (12.1%), paclitaxel (4.7%) and letrozol (4.7%). The median number of treatment regimens was 2, with a range of 1 to 6. The average resources utilization per patient/year included 1.85 plain thorax x-rays, 0.57 thorax CTs, 1.06 abdominal ultra-sounds, 0.46 abdominal CTs and 0.86 bone scintigraphies. The average survival of patients after first breast cancer diagnosis was 44.8 months (SD: 35.8; median: 32.0) and after first diagnosis of metastasis was 22.4 months (SD: 20.0; median: 16.1). The average survival post progression to anthracyclines and taxanes was 12.7 months (SD: 12.4; median: 8.4). CONCLUSIONS Within the Brazilian public health care system, the most frequently used first and second line treatments, for MBC.