Breast cancer is the most common cancer diagnosed in women in Western countries. Many of these patients develop metastatic disease in the course of their illness. One of the goals of treating patients with metastatic breast carcinoma is to provide palliation and improve their quality of life. It is usually assumed that the number and severity of symptoms caused by the tumour will be decreased by chemotherapy, and that there is a direct relationship between the tumour load and its symptomatic effect on the patient. A few studies have shown that objective responses to chemotherapy are associated with improvement of various parameters of the quality of life of these patients. The aim of our study was to evaluate quality of life parameters in patients with metastatic breast carcinoma and assess the  differences between women receiving chemotherapy and those undergoing supportive care interventions. 210 patients with metastatic breast carcinoma were enrolled in this prospective, randomized, single-institution study. The primary outcome of the trial was quality of life assessment.. Quality of life was found to be statistically better in metastatic breast cancer women receiving chemotherapy than those under only supportive care. Statistically significant differences in favour of chemotherapy were also found in functioning subscales, symptom single-item questions and sexual functioning. Our findings suggest that chemotherapy in metastatic breast cancer women with good performance status represents the more rational therapeutic approach to quality of life improvement.