The purpose of this study was to determine whether the triterpene glycosides present in black cohosh enhance the growth inhibitory effects of specific breast cancer chemotherapy agents. Black cohosh roots and rhizomes were extracted with methanol (MeOH)/water (H (2)O) and fractionated by solvent-solvent partitioning to yield three fractions: hexane, ethyl acetate (EtOAc) and water. The EtOAc fraction is enriched in triterpene glycosides, including the compound actein. Actein and the EtOAc fraction were then tested, alone and in combination with chemotherapy agents, for growth inhibition of the ER (-) Her2 overexpressing breast cancer cell line MDA-MB-453. We found that actein exerted a synergistic effect on growth inhibition when combined with doxorubicin or 5-flourouracil. Synergy was also obtained when the EtOAc fraction was combined with doxorubicin. Actein increased the percent of cells in the G1 phase of the cell cycle and had a similar effect when combined with 5-flourouracil or doxorubucin. Actein enhanced the induction of apoptosis by paclitaxel, 5-flourouracil or doxorubicin. Our results indicate that relatively low concentrations of actein or the EtOAc fraction of black cohosh can cause synergistic inhibition of human breast cancer cell proliferation when combined with different classes of chemotherapy agents.