What Is Metastatic Breast Cancer?
- Metastatic breast cancer is a condition in which cancer cells have spread from the breast to other parts of the body.
- Among women who are seeking medical attention for breast cancer for the first time, approximately 6 to 8% have evidence of metastatic breast cancer.
- Individual treatment options depend on the stage, type of primary breast cancer, and whether hormone receptors are positive. There is no one size fits all treatment.
Metastasis simply refers to the spreading of a disease from one part of the body to another part. It can occur in any form of cancer, although some types are more likely to metastasize. This includes HER-2 positive and triple-negative breast cancers, which tend to be more aggressive.Read More
- Local: Cancer is located in the breast and has not spread
- Regional: Cancer spreads from the breast to nearby lymph nodes
- Distant: Cancer spreads to distant parts of the body including bones, liver, lungs, and/or brain
How Common is Metastatic Breast Cancer?“Among women who are seeking medical attention for breast cancer for the first time, approximately 6 to 8% have evidence of metastatic breast cancer,” says Dr. Kenneth D. Miller, medical oncologist at the Alvin & Lois Lapidus Cancer Institute at Sinai Hospital of Baltimore, co-author of The Breast Cancer Book, and the past director of outpatient oncology at the University of Maryland’s Greenebaum Cancer Center.
“For women who present initially with earlier stage breast cancer, about 20% will later develop metastatic disease.” According to the American Cancer Society, more than 150,000 women were living with metastatic breast cancer as of early 2019. Of those, three-quarters were originally diagnosed with stage I, stage II, or stage III disease.
How Does Breast Cancer Spread?
Breast cancer spreads through the bloodstream or lymphatic system. The blood carries cancer cells to different parts of the body where they begin to grow as new tumors.
Once breast cancer spreads, the cancer cells may continue to grow slowly or they can stop growing and stay at equilibrium. It’s not known what makes them either grow or stop growing.
Breast cancer may metastasize after initial breast cancer treatment is finished. If any cancer cells are left behind after treatment, they may grow and spread to other parts of the body. This can happen years after successful treatment of the original breast cancer.
Symptoms of Metastatic Breast Cancer
Metastatic breast cancer is also called stage IV breast cancer because it occurs outside the breast. This type of breast cancer can be more difficult to diagnose and treat. Some women with this disease may experience no symptoms at all.
“Symptoms of recurrent breast cancer can vary significantly because they are related to where in the body the cancer metastases to,” says Dr. Miller. “Women who have bone metastases may complain of bone pain. Metastases to the lung may cause shortness of breath. Sometimes a cancer recurrence is detected on a physical exam or with blood tests.”
The most common breast cancer symptoms include:
- A new lump in the breast
- Swelling or redness
- Changes in the breast or nipples appearance (puckering of the skin, inverted nipples)
- Pain in the breast
- Nipple discharge
As the disease spreads to other areas of the body (metastasis), it may cause additional symptoms depending on the area the cancer has spread:
- 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
Treatment for metastatic breast cancer focuses on decreasing the spread of cancer cells, as well as relieving symptoms and improving quality of life. Individual treatment options depend on the stage, type of primary breast cancer, and whether hormone receptors are positive. There is no one size fits all treatment.
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
An overview of treatment options for metastatic breast cancer
Can Metastatic Breast Cancer be Prevented?
While there’s no sure way to prevent metastatic breast cancer, researchers are working diligently to find ways you can prevent the first (or primary) breast cancer from returning or metastasizing.
Dr. Miller recommends making lifestyle adjustments to reduce risk factors and improve cancer survivorship, including:
- Eat a low-fat diet: Women who eat a low-fat diet tend to have lower levels of estrogen in their blood, which could help reduce risk.
- Choose a colorful diet: Women who eat a varied diet of fruits and vegetables may have a lower risk of developing breast cancer.
- Exercise for two or more hours weekly: Studies suggest that physical activity can lower breast cancer recurrence.
- Maintain a healthy body weight: Women who are overweight after treatment for breast cancer may be at higher risk of recurrence
- Limit alcohol intake: Heavy alcohol consumption has been linked to an increased risk of recurrence.
Maintaining Quality of Life With Metastatic Breast Cancer
“Metastatic breast cancer is a treatable disease,” explains Dr. Miller. “Fortunately, we have so many new treatments for women with recurrent breast cancer and for many women who look at this as a chronic disease that they can live with—often for many years.”
While treatment for metastatic breast cancer is not curative, it can improve your quality of life. You and your doctor will work together to develop a treatment plan that’s right for you.
“Quality of life typically involves many things including treating symptoms effectively and modifying lifestyle to allow time for treatment and to accommodate to living with a chronic disease. A positive attitude doesn’t cure cancer but also contributes to living well with cancer. Faith, spirituality, intimate relationships, friends, and families help as well.”
In some cases, you may need more aggressive therapies that can be lifesaving. Finding the right combination of treatments for your breast cancer and your body may take some time. Be patient and work with your doctor to arrive at the right treatment plan.
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