The approach that works for me is a combination of light suckering, staking and caging. I drive in one of those long green plastic coated poles from home depot and then place a big round tomato cage around it. Next I tie the cage off to the pole, then plant the tomato smack-dab in the center.
As the plant grows, remove the first few suckers until the plant is about half way up the cage. I don't remove any more suckers from then on as they tend to bear fruit. As the plant grows out of the cage, tie off the various branches to the pole with twine.