A 50-year-old woman presented with local relapse ofbreast cancer 6 years after partial mastectomy. Relapse wasaccompanied by extended skin induration due to tumor cellembolization of dermal lymphatics. During the following yearsthe patient was exposed to 11 different anti-tumor regimensincluding 13 cytotoxic drugs (including alkylating agents,antitumor antibiotics, vinca alcaloids, epipodophyllotoxins,and taxanes), 4 anti-hormonal, and 2 immunologic attempts.Paclitaxel achieved a prolonged local improvement for some 7months, but further various treatments were ineffective. Atthat time gemcitabine therapy was initiated and tumorinfiltration of the skin was visibly diminished only 2 weekslater. After that tumor regressed further for 5 months andremained stable with continued doses of gemcitabine duringmuch of the woman's last year. The patient died of acutemyeloid leukemia (AML) 4 years after the local recurrence ofbreast cancer. Since multiple treatments using a plethora ofaggressive cytotoxic drugs may render several classes ofchemotherapy agents ineffective due to cross-resistance, itseems advisable to select mild agents that are not subject tomultidrug resistance mechanisms and display a unique mode ofaction as demonstrated in this case by gemcitabine.