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Breast cancer (BC) is the most frequently diagnosed cancer among women and the leading cause of cancer deaths in females globally. In the United States, more than 300,000 new cases of invasive BC are diagnosed annually, and more than 40,000 patients die of metastatic BC. Herein, we discuss the current and evolving management of invasive BC. Despite major progress, ongoing challenges include how best to optimize treatment based on BC subtype and how to address treatment resistance for patients with metastatic BC. Efforts to further refine surgical approaches, radiation therapy, and preoperative and postoperative systemic therapies are under way, as are attempts to further elucidate the utility of immunotherapy and targeted therapies in various BC care settings.