OBJECTIVES: Breast cancer is the most common cancer among women. Several treatments are available, but there is no comprehensive overview which covers both treatments and QALY. The objective of this study was to conduct a systematic review of the treatments and QALY for breast cancer patients. METHODS: Electronic, manual, and bibliographic searches of OVID, EMBase, and PubMed were conducted expanding from 1990 to 12/21/06. Randomized clinical trials evaluating different interventions on breast cancer in QALY were included. Breast cancer and QALY were used as the key words. Among 169 articles, 15 articles are included for this full-text review. RESULTS: Hormone therapy, chemotherapy and prophylactic surgery were three major methods of treating breast cancer. Among these articles, 56% of them mentioned letrozole and tamoxifen or their combination therapy, which were targeted for postmenopausal women with early stage breast cancer. More QALYs were gained within the range from 0.1 to 0.36 in 5 years'for (i) tamoxifen followed by letrozole compared with tamoxifen only or (ii) letrozle as the first line therapy followed by tamoxifen therapy compared with letrozole as the second-line therapy. Moreover, anastrozole and exemestane also increased QALYs in postmenopausal with ER(+) breast cancer patients. Capecitabine/docetaxel and CMF could increase quality-adjusted survival and relapse-free survival 1.8 and 1.5 years compared with no treatments. Routine postoperative radiotherapy after sector resection and ancillary dissection or conservative surgery for early-stage breast cancer women would also gain QALYs compared without postoperative radiotherapy. CONCLUSION: Very few studies have been found using QALY to evaluate different interventions to treat breast cancer patients in the different stages. Patients should adopt treatments based on their own age and the stage of breast cancer. Further research on breast cancer interventions is needed to understand the cost-effectiveness of alternative or combining treatments in order to establish standard treatments for breast cancer.