Abstract: Objective To characterize the sites of distant recurrence and clinical outcomes in a cohort of Chinese patients with metastatic Her-2 positive breast cancer. Methods One hundred and fourteen patients with metastatic Her-2 positive breast cancer treated at Shandong Tumor Hospital from January 2002 to December 2008 were included in this study.The clinicopathologic features and long-term survival of the patients were retrospectively analyzed. Results The median age of the patients was 46 years.8 patients presented with stage Ⅳdisease,106 patients presented withⅠ- Ⅲ stage.By August 15th,2011,58 patients were died(51.0%).The median OS of patients with CR/PR was significantly longer than that of patients with SD/PD.Distant metastasis,first-line chemotherapy and clinical response were signi ficantly related with OS by univariate analysis.Furthermore,first-line chemotherapy and clinical response were demonstrated to be independent prognostic factor by multivariate analysis. Conclusion Recurrence risk and mortality are considerably higher in advanced Her-2 overexpressed breast cancer patients with the early years follow-up.Advanced Her-2 overexpressed breast cancer is aggressive clinical behavior.Our findings also suggest that chemotherapy can effectively improve the outcome of those patients.