Living With Metastatic Breast Cancer
- At just 33, Hayvne Cooper had no family history of breast cancer and was focused on celebrating her birthday after earning her Master’s in Counseling — until a persistent lump led her to push for imaging and receive a stage 4 diagnosis.
- Cooper’s insistence on further testing, despite initial dismissal by her doctor due to her age and health, revealed metastatic breast cancer and launched her into aggressive treatment: chemotherapy, radiation, and a double mastectomy.
- Metastatic breast cancer means the cancer cells have spread from the breast to other parts of the body. Breast cancer spreads through the bloodstream or lymphatic system. The blood carries cancer cells to different body parts, where they grow as new tumors.
- Some of the newer treatments for advanced breast cancer include imlunestrant. This treatment, which received approval from the U.S. Food and Drug Administration, is the second oral selective estrogen receptor degrader (SERD) for adults with estrogen-receptor–positive (ER+), HER2-negative, ESR1-mutated advanced or metastatic breast cancer whose disease has progressed after at least one line of endocrine therapy.
- For women with a common type of advanced breast cancer — hormone receptor-positive (HR+), HER2-negative (HER2-), a new drug combination — camizestrant plus a CDK4/6 inhibitor reduced the risk of disease progression or death by 56% in patients with HR+ breast cancer and an emerging ESR1 mutation.
Cooper had just earned her Master’s in Counseling and was looking forward to celebrating her birthday. Cancer wasn’t even a blip on her radar. But a small lump on her breast — one she initially dismissed — would soon upend everything.
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“When I found that lump, I was like, there’s no way, because there’s no family history. I’m only 33. I’m healthy,” Copper said.
WATCH: Understanding Metastatic Breast Cancer
Surprisingly, her doctor agreed and didn’t probe the lump further. The thought at the time was that, at her age, with no family history of breast cancer, the lump seemed unlikely to be serious. But Cooper couldn’t shake the feeling that something wasn’t quite right. She then pushed for imaging — and that decision changed her life.
“I’m really grateful that I had the courage to stand up to my doctor and ask for that imaging,” she said.
The results revealed stage 4 metastatic breast cancer — an aggressive form that had already spread beyond the breast. While not curable, metastatic breast cancer can be treated to extend life and improve quality of life.
Cooper began an intense treatment regimen: six rounds of chemotherapy, 22 rounds of radiation, and a double mastectomy — a surgery that removes both breasts.
“A double mastectomy typically takes about two hours for the cancer part of the operation,” explained Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System. “The real length of the surgery can often depend on what type of reconstruction a patient has.”
For many women, the decision to undergo a mastectomy is deeply personal. The physical changes can be profound, and the mental adjustment can take time.
Cooper is now in remission and preparing for breast reconstruction — a step toward reclaiming her body and her sense of self.
WATCH: Breast Reconstruction: Regaining Your Sense of Self
“Breast reconstruction is a restoration of a woman’s form and her sense of self,” said Dr. Andrea Pusic, Chief of Plastic and Reconstructive Surgery at Brigham and Women’s Hospital. “All these different techniques are getting close to that goal of letting a woman be herself again.”
Cooper’s story is a powerful reminder of the importance of self-advocacy — especially when something doesn’t feel right.
“I recommend that we all have the courage,” Cooper said.
“You know, courage is having fear and continuing to move forward, and it’s really scary, but we have to do the things that are going to save our lives,” she continued.
WATCH: How to Advocate for Yourself
Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center, recommends that patients go into each doctor’s appointment with a plan.
“My plan would be, hey, doc, I would prefer to see whether or not this treatment you have works. But let me come back in a month. If it’s not working in a month, what would the next step be? And the doctor should be able to tell you, well, if it’s not working in a month, then I would do this,” Dr. Murrell explained while encouraging patients to advocate for themselves more assertively.
Expert Resources on Metastatic Breast Cancer
- CD4/CD6 Inhibitors For Metastatic Breast Cancer — What Are The Side Effects?
- Debt Collectors Are Hunting Half of Women with Metastatic Breast Cancer — Help Us, Please!
- Chemo Plus Immunotherapy for Metastatic Triple-Negative Breast Cancer
- Metastatic Breast Cancer: Biomarkers and Mutations That Matter
- Elacestrant (Orserdu) Offers Hope for Patients With a Stubborn Form of Metastatic Breast Cancer
- FDA Approves Diagnostic Test to Identify Patients with Metastatic Breast Cancer Expressing Low Levels of HER2
- How Does Piqray Work For HER2-Negative, HR+ Metastatic Breast Cancer?
- HER2-Positive Metastatic Breast Cancer Treatment Options Explained
- PARP Inhibitors Provide New Promise for Certain Metastatic Breast Cancers
Discovering the Latest Treatments for Advanced Breast Cancer
Late-stage breast cancer is not one disease, but many different diseases, so the options available to different patients vary a great deal. Which treatment doctors recommend will depend on several factors, such as a woman’s overall health, genetics, the biology of the tumor, and more.
Some of the newer treatments for advanced breast cancer include imlunestrant. This treatment, which received approval from the U.S. Food and Drug Administration, is the second oral selective estrogen receptor degrader (SERD) for adults with estrogen-receptor–positive (ER+), HER2-negative, ESR1-mutated advanced or metastatic breast cancer whose disease has progressed after at least one line of endocrine therapy.
WATCH: New Hope For 70% Of Advanced Breast Cancer Patients
During clinical trials, imlunestrant demonstrated a meaningful improvement in progression-free survival (PFS) as a stand-alone therapy in patients with an ESR1 mutation versus the standard of care endocrine therapy, reducing the risk of disease progression or death by 38%.
For women with a common type of advanced breast cancer — hormone receptor-positive (HR+), HER2-negative (HER2-), a new drug combination — camizestrant plus a CDK4/6 inhibitor reduced the risk of disease progression or death by 56% in patients with HR+ breast cancer and an emerging ESR1 mutation.
Help Coping With Hair Loss During Treatment
Hair loss can be an emotional stage of anyone’s cancer journey. SurvivorNet has tips and resources for anyone facing this side effect and struggling to manage it.
“For cancer patients, losing one’s hair can be unbelievably stressful. To start with, the dread of losing one’s hair can lead to some sleepless nights and feelings of anxiety,” Dr. Samantha Boardman, a New York-based psychiatrist and author, told SurvivorNet.
Chemotherapy can cause hair loss. It usually begins about three to four weeks after chemotherapy and continues throughout treatment.
WATCH: Hair loss during chemo.
This happens because this treatment targets quickly dividing cells throughout the body, including cancer cells and hair cells.
Radiation is another treatment that can lead to hair loss if the hair is in the path of the tumor being treated. For example, radiation for a brain tumor may cause hair loss on the head.
“If you do lose hair, it will regrow several weeks or months after treatment,” radiation oncologist at GensisCare, Dr. James Taylor, tells SurvivorNet.
“Fortunately, for most patients, hair loss is not a concern when having radiation therapy.”
Most patients can expect regrowth four to six weeks after treatment. However, when your hair grows back, you may notice some changes in its color and texture.
WATCH: What is a scalp-cooling device?
Cold capping (also called cryotherapy) is a Scalp-cooling device. The FDA recently approved this type of device, first for breast cancer and then for several other cancers. That means wearing cold caps or special cooling caps before, during, and after each chemotherapy treatment. The caps, which are tightly fitting and strap-on helmet-style, are filled with a gel coolant that’s chilled to between -15 and -40 degrees Fahrenheit.
Essentially, the caps “cause vasoconstriction, or a narrowing of the blood vessels bringing blood to the scalp,” Dr. Renata Urban, gynecologic oncologist at the University of Washington, explains.
By constricting the blood flow to the scalp, the caps limit the circulating chemotherapy that reaches the hair follicles, protecting them from some of the chemo’s damaging effects.
The cold also decreases the activity of the hair follicles, slowing down cell division and making the follicles less affected by the chemotherapy medicine.
If losing your hair is a concern before cancer treatment, know you have options like wigs, hats, wraps, and more.
Treatment Options for Advanced Breast Cancer
Metastatic breast cancer means cancer cells have spread from the breast to other parts of the body, which may include the bones, liver, lungs, brain, and beyond.
Breast cancer spreads through the bloodstream or lymphatic system. The blood carries cancer cells to different body parts, where they grow as new tumors.
As the cancer spreads to other body parts, patients may experience additional symptoms depending on where the cancer has spread. Examples include:
- Bones: Severe bone pain or fractures
- Lungs: Difficulty breathing, chest pain, new cough
- Liver: Yellowing of the skin (jaundice), abdominal pain, nausea, and/or vomiting
- Brain: Headaches, memory loss, changes in vision, seizures
WATCH: Treatment options for metastatic breast cancer.
Although stage 4 breast cancer is not curable, several treatment options exist that can extend the life of patients. Treatment options depend on the stage, type of primary breast cancer, and whether hormone receptors are positive.
Treatment can include a combination of:
- Chemotherapy: Oral or IV medications that are toxic to tumor cells
- Hormonal therapies: Drugs that lower estrogen levels or block estrogen receptors from allowing the cancer cells to grow
- Targeted therapies: Drugs that target your tumor’s specific gene mutations
- Immunotherapy: Medications that stimulate your immune system to recognize and attack cancer cells
- Radiation: The use of high-energy rays to kill tumor cells and shrink tumors
- Surgery: To remove a cancerous tumor or lymph nodes (uncommon with stage IV; more common in stages I, II, and III)
- Clinical trials: Studies of new medications, treatments, and other therapies offer hope for better outcomes
Questions for Your Doctor
If your breast cancer journey involves metastasis, you may be wondering what to expect and if radiation therapy is an option for you. Here are some questions you can ask your doctor to get the conversation started:
- What type of breast cancer do I have? Does it have a risk of spreading?
- Does my breast cancer have a risk of spreading to my brain?
- Will radiation help treat the cancer in my brain? What type of radiotherapy do you recommend?
- How long does radiation treatment typically last? Will I have to take time away from work and daily activities?
- Would I be on any other forms of treatment while receiving radiation?
- How do you expect my cancer to respond to the treatment?
- What financial resources are available to me to help cover costs associated with radiation treatment?
- What’s the efficacy of radiation treatment?
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