The prognosis of high-risk BC patients has changed very little in the past 2 decades with the use of conventional chemotherapy.

High-dose chemotherapy (HDC) with autologous hematopoietic stem cell transplantation (AHSCT) is today a safe treatment modality with low toxicity.

The efficacy of HDC and AHSCT for high-risk BC has been an area of intense controversy among the medical oncology community.

Phase II studies suggested that this approach improved long-term disease control.

Preliminary reports from randomized studies did not showed an overall survival benefit.

Nevertheless, HDC might be of potential benefit in subgroups of high-risk BC patients.

As a contribution to this field, we report the results of this approach in a large cohort of high-risk BC patients treated in Europe between 1995 and 2005.