What is metastatic breast cancer?
The most advanced stage of breast cancer is metastatic breast cancer. Breast cancer occurs when abnormal cells divide uncontrollably in the breast. Tumors are masses of these abnormal cells.
Metastasis refers to the spread of cancer cells to a new part of the body. Metastatic breast cancer cells can spread to:
- Bones.
- Brain.
- Liver.
- Lungs.
Cancer is named based on its primary cause. Breast cancer that spreads to other parts of the body is still considered breast cancer. Cancer cells are still cancer cells. Breast cancer therapies will be used, even when the cancer cells are in other places.
Is there a difference between metastatic breast cancer and stage 4 breast cancer?
Both terms refer to the same thing. Stage 4 breast cancer has spread beyond the breast, or metastatic, to other parts of the body.
When do people get a metastatic breast cancer diagnosis?
There are different stages of metastatic breast cancer:
- A little over 6% of women and 9% of men are diagnosed with metastatic breast cancer when they are first diagnosed with breast cancer.
- Metastatic breast cancer is most commonly diagnosed after the initial breast cancer treatment. Recurrence refers to cancer that returns and spreads to another part of the body, which can occur even years after the original diagnosis and treatment.
Who is at risk for metastatic breast cancer?
Metastatic cancer is a risk for some people after completing cancer treatment. The risk depends on several factors, including:
- Cancer characteristics (type of cancer cells).
- The stage at the time of diagnosis.
- Type of treatment.
How common is metastatic breast cancer?
In the United States, about 170,000 people have metastatic breast cancer. Women diagnosed with early-stage breast cancer are less likely to develop metastatic breast cancer.
CAUSES AND SYMPTOMS
There are a number of causes for metastatic breast cancer:
- Lymph nodes and blood vessels can be invaded by cancer cells. These cancer cells can then travel throughout the body via lymph vessels or blood vessels. Blood and fluid travel through these vessels. These cancer cells may form small tumors at their new location.
- Metastatic cancer occurs when the treatment did not destroy all cancer cells. In some cases, a few cells remain dormant or are hidden. Then, for reasons we do not fully understand, the cells begin to grow and spread again.
- As breast cancer is being diagnosed, it already spreads to other parts of the body. The cancer spreads without treatment.
It is impossible to prevent breast cancer from metastasizing. Metastatic breast cancer does not happen by accident.
What are the symptoms of metastatic breast cancer?
The symptoms you experience depend on where cancer cells have invaded:
Bone metastasis symptoms include:
- Bone pain.
- Bones that break or fracture more easily.
- Swelling.
Symptoms of brain metastases:
- Worsening headaches or pressure in the head.
- Visual disturbances.
- Seizures.
- Nausea and vomiting.
- Behavior or personality changes.
Symptoms of liver metastases:
- Jaundice.
- Itchy skin or rash.
- Stomach pain, loss of appetite, nausea, and vomiting.
Symptoms of lung metastases:
- Cough that won’t go away.
- Difficulty catching your breath.
- Chest pain.
Other symptoms of metastatic breast cancer:
- Fatigue.
- Poor appetite.
- Unexplained weight loss.
Additional signs of metastatic breast cancer can include:
- Liver test showing high enzymes.
- Chest X-ray that shows signs of a problem.
DIAGNOSIS AND TESTS
How is metastatic breast cancer diagnosed?
Your provider may recommend these tests if you have symptoms of metastatic breast cancer:
- Complete blood count and comprehensive metabolic panel.
- Imaging studies such as MRI, CT, bone scan, and PET.
- A bronchoscopy, which uses a scope to look into your lungs, can be performed if there is a concern in your lungs.
- A biopsy involves the removal of tissue from a suspicious area and its analysis.
- A tap removes fluid from an area that has symptoms. A tap removes fluid from an area that has symptoms. The tap removes fluid from an area that has symptoms. Pleural taps remove fluid from the lung area. Spinal taps remove fluid from the spinal cord area.
MANAGEMENT AND TREATMENT
Can metastatic breast cancer be cured?
There is no cure for metastatic breast cancer. Cancer cells cannot be eradicated once they have spread to another part of the body. The right treatment plan, however, can improve the quality of your life and help you live longer.
Metastatic breast cancer treatment aims to shrink tumors, slow their growth, and improve your symptoms.
What is the treatment for metastatic breast cancer?
Systemic therapy is the main treatment for metastatic breast cancer. These therapies target the entire body. A combination of these therapies may be used to treat metastatic breast cancer.
- Chemotherapy.
- Immunotherapy.
- Targeted therapy.
- Hormonal therapy.
You will be treated based on the following factors:
- Parts of the body have been affected by cancer.
- I have undergone breast cancer treatment.
- I have symptoms.
- The biology of the cancer cells.
Why does my provider need to test my metastatic tumor?
Your care team will test the metastases to determine the biology of the tumor, which can help guide your treatment. Tests may include:
Your care team will test the metastases to determine the biology of the tumor, which can help guide your treatment. Tests may include:
- Hormone receptor (estrogen and progesterone) status: If the cancer is hormone receptor-positive, hormonal therapy may be a good option.
- HER2 status: Human epidermal growth factor receptor 2 is overexpressed in some breast cancer cells. Cancer that is HER2-positive responds to specific HER2-targeted therapies.
- PIK3CA gene mutation: If a tumor is hormone receptor-positive and HER2-negative, your provider will likely test for this mutation. Targeted therapies can be used to treat tumors with this mutation.
- PD-L1 status: Tumors that are hormone receptive-negative and HER2-negative may be tested for PD-L1. You may be recommended to receive a combination of immunotherapy and chemotherapy if you test positive for PD-
For metastatic breast cancer, how long will treatment last?
Metastatic breast cancer is treated indefinitely. You may also decide to stop treatment if you cannot or do not wish to tolerate the side effects. Cancer treatment side effects can be unpleasant.
For metastatic breast cancer, will I need more than one treatment?
To control the spread of metastatic breast cancer, medications are essential. If you develop resistance to therapies, your care team may recommend a change in treatment.
As you begin a treatment regimen, you and your care team will see how:
- The therapy is effective in treating cancer.
- The side effects impact you.
If the treatment isn't working or the side effects are unbearable, your care team can suggest changing the method. They may suggest a different drug, dosage, or schedule.
There are many treatment options available. There is usually another therapy you can try if one doesn't work for whatever reason.
Will I need surgery for metastatic breast cancer?
Generally, healthcare providers do not recommend breast cancer surgery for metastatic breast cancer. In cases where cancer has spread to more than one part of the body, surgery is unlikely to help.
Surgery may help in some cases:
- Avoid breaking bones.
- Get rid of liver blockages.
- Reduce pain.
Is radiation therapy necessary for metastatic breast cancer?
For metastatic breast cancer, radiation therapy is not a typical treatment. However, your provider may recommend it in some cases. Radiotherapy, for instance, can ease pain or control the growth of cancer in a specific area.
PREVENTION
Can metastatic breast cancer be prevented?
Currently, there is no proven way to prevent metastatic breast cancer. Researchers are developing treatments that might prevent cancer from spreading and returning (recurring).
How can I reduce my risk of getting breast cancer?
The earlier breast cancer is detected, the more effective the treatment can be. When cancer is diagnosed and treated at an earlier stage, the outlook is usually better. Consult your provider about when you should start having regular breast exams and mammograms.
PROGNOSIS / OUTLOOK
What’s the outlook for metastatic breast cancer?
People with metastatic breast cancer can live longer if they follow the right treatment plan. Survival rates vary and are determined by a variety of factors, including the type and biology of breast cancer, the parts of the body involved, and the characteristics of the individual. About one in three women survive at least five years after diagnosis. Some live for as long as ten years. You will discuss your prognosis with your care team in more detail.
Living with Metastatic Cancer.
How can I take care of myself while living with metastatic breast cancer?
Metastatic breast cancer can be challenging to live with. Your care team can assist you by providing physical and emotional support. You can:
- Choose the most nutritious diet that suits your needs.
- Control your stress.
- Look for emotional support, including support groups.
- Seek help from friends, family, and loved ones.
- Find mental health services.
- Find complementary therapies.
- Exercise regularly.
What can I expect while living with metastatic breast cancer?
Your care team will monitor you every few months to check if the cancer is responding to treatment, and also to see if you are having any side effects. The process of “restaging” cancer includes:
- History/physical exam.
- Blood tests.
- Imaging tests, including CTs and bone scans or PET scans.
Before your scans or tests, it’s normal to feel anxiety. It may help to bring a friend or family member to the appointment with you.
Can metastatic breast cancer go into remission?
Metastatic breast cancer may never completely disappear. However, treatment can slow its progression. In some cases, cancer may even go into remission. If this happens, you may have fewer signs and symptoms of cancer.
When someone is experiencing intolerable side effects or remission, a treatment break may be considered. Taking a break from treatment can help you feel better and improve your quality of life.
What if I decide to stop treatment for metastatic breast cancer?
Whether you receive treatment or stop it is up to you. Your healthcare team can help you think about and plan this next step.
Consider how to:
- Take steps to manage symptoms.
- Get your finances in order.
- Consider hospice care.
- Have difficult conversations with family and loved ones.
What should I ask my healthcare provider about metastatic breast cancer?
If you have been diagnosed with metastatic breast cancer, ask your provider:
- What treatment options are available to me?
- What are my prospects?
- What are the side effects?
- Can complementary therapy help me?
- What if I want to stop the treatment?
- What can I do to feel my best during treatment?