A Note From Dr Halls Regarding The Statistics For Metastatic Recurrence In Breast Cancer
The statistic of 20% to 30% for metastatic breast cancer that recurs remain controversial amongst medical experts. The figure of 30% metastatic breast cancer recurrence rate first appears in a 2005medical study, but no statistical data or sources are cited.
The MBCN take the 18-year relative survival rate from the SEERS data between the years of 1990 to 1994 as 71%. The argument is, that this takes us close to the 30% recurrence rate statistic. However, there are many other factors at play and treatment has advanced so much that recurrence rates may have even halved since then.
It is safe to say that much more data and research into metastatic recurrence rates would be of huge value towards a long-term cancer cure.
Indeed, it has also been suggested that research into the rare group of women who survive many years with metastasis may be of equal importance to understanding recurrence and patterns of breast cancer.
Treatment Options For Metastatic Breast Cancer
Treatment for metastatic breast cancer often is based on systemic therapies, which use drugs rather than surgery or radiation. Metastases treatments are designed to shrink tumors and slow their growth, help ease symptoms and improve quality of life. Treatment may change, such as when one therapy stops working, or the side effects become too uncomfortable. Rather than having only one treatment, most patients undergo several treatments combined to help fight the cancer.
The four broad categories of drug-based treatments are:
Advances In Treatment Of Metastatic Breast Cancer With Bone Metastasis
Ziping Wu, Jinsong Lu
Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University , China
Contributions: Conception and design: All authors Administrative support: None Provision of study materials or patients: All authors Collection and assembly of data: All authors Data analysis and interpretation: All authors Manuscript writing: All authors Final approval of manuscript: All authors.
Correspondence to:
Abstract: Bone is the most commonly seen metastatic site in all the metastatic breast cancer . Treatment includes systemic treatment according to different molecular subtypes and specified treatment of the bone. Bisphosphonate and denosumab are the only two drugs approved to use in bone metastatic site. The optimal dosing schedule and duration of the drugs are still under research. New drugs and therapies including curcuminoids, sunitinib and nano particles are potentially available in the near future.
Keywords: Metastatic breast cancer bone metastasis bisphosphonate denosumab
Submitted Jun 01, 2018. Accepted for publication Jun 07, 2018.
doi: 10.21037/cco.2018.06.05
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What Is The Life Expectancy Of Stage 4 Cancer
Stage 4 cancer cells have metastasized, spreading to distant areas in the body. Stage 4 is the final stage of mesothelioma and considered terminal. The average life expectancy for stage 4 mesothelioma is less than 12 months. Watch: Learn what to expect after receiving a stage 4 mesothelioma diagnosis.
Integrative Therapies For Metastatic Breast Cancer
You may find it beneficial to add integrative therapies to your treatment plan. There are many evidence-informed integrative modalities to boost the mind and body. Practices like gentle yoga, meditation, massage and music therapy may feel enjoyable and reduce stress and anxiety levels.
To help our patients maintain quality of life after a metastatic breast cancer diagnosis, our team of breast cancer experts may offer supportive care services to help manage side effects of the disease and its treatments. These may include:
Before starting any integrative therapies, however, ask your care team for advice on which ones are most suited to you and fit into your overall treatment plan, as well as how to do them safely.
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Breast Cancer Subtypes Hormonal And Her2 Status And Survival Rates
Many research studies over the years have shown that Estrogen-positive breast cancers have better survival rates than all of the Estrogen-negative subtypes.
Progesterone-positive breast cancer also appears to have improved survival rates in comparison to progesterone-negative cases.
A recent research study combines hormone receptivity, HER2 status and stage and found some interesting results:-
For ER+ sub-types survival rates were significantly better than all other subtypes. For example, at stage 1b,
ER+ PR+ HER2- 5-year survival rates were 98.6%ER+ PR- HER2+ 5-year survival rates were 97.3%
The subtype triple negative breast cancer had the worst survival rates over all three stages. At stage I the 5-year survival rate was 92.9% and at stage III 48.9%.
Positron Emission Tomography Scan
This is another nuclear scanning technique sometimes used to detect metastases by creating a 3-dimensional picture of your body, with the use of radio waves that show up after an injection. PET scans are not routinely used to look for bone metastases. If your doctor recommends that you have a PET scan you should speak to your doctor about possible costs as it is not usually covered by Medicare.
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Prognosis For Metastatic Breast Cancer
Metastatic breast cancer isnt the same for everyone who has it. According to the National Breast Cancer Foundation, your symptoms at stage 4 will depend on the degree to which the cancer has spread in your body.
Although metastatic breast cancer has no current cure, it can be treated. Getting the right treatment can increase both your quality of life and longevity.
Life expectancy for breast cancer is based on studies of many people with the condition. These statistics cant predict your personal outcome each persons outlook is different.
The following factors can affect your life expectancy with metastatic breast cancer:
Metastasis Breast Cancer To Bone Survival Rate
Breast cancer can spread to other parts of the body after stage 3 breast cancer diagnosis. Metastasis is the process by which breast cancer spread to bones and many more parts of the body.
Once it spreads into bones only 10 percent can survive a quality life for a short period.
As we discussed in earlier articles, it is a terminal disease and the patient will die in a short period of time.
According to a general study on the various patients of metastasis bone cancer there are nearly 6 to 48 months of life expectancy. Bones became so weak after cancer spread into them and it led to symptoms of secondary breast cancer.
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Breast Cancer Metastasis: Secondary Sites
Over the years there have been significant improvements and advancements in the diagnosis and treatment of breast cancer. Indeed, breast cancer is now considered to be a manageable disease.
However, there are still over half a million deaths worldwide from breast cancer and over 90% of these women die of metastasis. Consequently, research into metastasis is of vital importance in overcoming deaths from metastatic breast cancers.
Stage IV or metastatic breast cancer, as mentioned earlier, are cancer cells that have spread from the breast to distant sites around the body. Common secondary sites are:-
Benefits Of Primary Tumor Surgery In Patients Subdivided By Molecular Subtypes And Metastatic Sites
In the whole cohort, primary tumor surgery could prolong OS . In terms of molecular subtypes, surgery provided extra survival benefit in all subtypes . In terms of metastatic burden, BOM, bone and liver metastasis as well as bone and lung metastasis patients could benefit from surgery . However, surgery did not significantly benefit patients with bone and brain metastasis . Similarly, the analysis of BCSS showed consistent results.
Figure 4 Survival of de novo bone metastatic patients in different subtypes according to primary surgery. OS and BCSS in patients with HR+/HER2 tumors OS and BCSS in patients with HR+/HER2+ tumors OS and BCSS in patients with HR/HER2+ tumors OS and BCSS in patients with HR/HER2 tumors.
Figure 5 Survival of de novo bone metastatic patients in different metastatic burdens according to primary surgery. OS and BCSS in patients with bone-only metastasis OS and BCSS in patients with bone and brain metastasis OS and BCSS in patients with bone and liver metastasis OS and BCSS in patients with bone and lung metastasis.
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Bone Metastases And Bone Problems
People with bone metastases are at risk of serious bone complications such as bone fractures , spinal cord compression and bone pain.
Bone complications are a concern for people with bone metastases as they can cause pain and may lead to loss of mobility, impacting quality of life. Bone complications can also decrease survival . With the use of bone-strengthening drugs, bone complications are not common .
Prognosis Of Bone Metastases
Once cancer has spread to the bone, prognosis tends to be poor and treatment is generally aimed at minimizing symptoms and improving quality of life. Bone metastases often have a significant impact on a persons quality of life by causing reduced mobility and pain, and complications such as high calcium levels, bone marrow suppression and fractures.
Here are some of the common problems caused by bone metastases. Not everyone will get all of these symptoms, and some of the information here may not apply to you. In some cases, these symptoms are not caused directly by the cancer in the bones or can have more than one cause. Your cancer care team can tell you the most about where the bone metastasis is and what symptoms it might cause.
Pain
There are many ways to treat pain caused by bone metastases. Almost any of the local or systemic treatments commonly used for bone metastases can be helpful in treating pain.
Pain medicines are also very helpful. There are many different kinds of pain medicines used to treat cancer pain. There are also a lot of ways the medicines can be taken, such as pills, patches, sprays, and pumps that let you put the medicine into your body when you need it.
You should never accept pain as a normal part of having cancer. All pain can be treated, and most pain can be controlled or relieved. Talk to your cancer care team.
High calcium levels
Early symptoms of having too much calcium in the blood include:
Broken bones
Spinal cord compression
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What Should I Ask My Healthcare Provider About Metastatic Breast Cancer
If youve been diagnosed with metastatic breast cancer, ask your provider:
- What are my treatment options?
- What is my prognosis?
- What side effects can I expect?
- Will complementary therapy help me feel better?
- What if I want to stop treatment?
- How can I feel my best during treatment?
A note from Cleveland Clinic
Metastatic breast cancer is advanced breast cancer. Providers classify it as stage 4 breast cancer. It happens when cancer cells, often left behind after previous breast cancer treatment, start to spread to other parts of the body. While there is no cure for metastatic breast cancer, treatment can prolong your life and help you feel better. There are many medications available, so if one treatment isnt working, your care team can try a different approach. If you notice any symptoms or dont feel your best, especially if youve undergone breast cancer treatment in the past, talk to your healthcare provider.
Last reviewed by a Cleveland Clinic medical professional on 04/14/2021.
References
Demographic And Clinical Variables
The relationship between metastatic sites and clinical characteristics, including age at diagnosis, year of diagnosis, race, marital status, tumor grade, tumor size, nodal status, subtype, and treatment was analyzed. Initial metastatic sites were registered as single or multiple and were categorized as bone-only, lung-only, liver-only, brain-only, other-only and multiple metastasis . Overall survival was calculated from the date of diagnosis to the date of death due to any cause, the date of last follow-up, or December 31, 2015. Breast cancer specific survival was measured as the time from the date of diagnosis to the date of death attributed to breast cancer. Both overall survival and breast cancer specific survival were used as endpoints.
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Univariable And Multivariable Analysis
In univariate analysis, we found that patients of older age, black race, higher grade tumors, HR/HER2 subtype, high T stage , unmarried status, uninsured status, visceral involvement , no primary tumor surgery displayed worse OS .
Table 2 Univariate and multivariate cox progression of OS and BCSS of breast cancer patients with initial bone metastasis.
These statistically significant factors were included in the multivariate analysis. Patients older than 60 years old , black race , T3 stage were significantly related to worse OS. Compared with HR+/HER2 patients, HR+/HER2+ and HR/HER2+ subtype showed improved OS , while HR/HER2 subtype demonstrated the worst outcome . Social factors like marital status and insurance status were also associated with OS.
Among the 6,860 patients with bone metastatic lesions, 4096 cases demonstrated bone-only metastasis and 2,764 cases displayed concurrent visceral metastases. The outcome was much worse when combining visceral metastases . In terms of BCSS, univariate and multivariate results identified the same prognostic factors as OS .
How Long Do You Live With Stage 4 Breast Cancer
The 5-year relative survival rate for stage 4 breast cancer is 22 percent, which means that 22 percent of people will live for at least 5 years after diagnosis. However, many factors influence survival rates, including: the subtype of breast cancer. how fast the tumor is growing. how likely the cancer is to come back.
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When Can Metastatic Breast Cancer Occur
Most often, metastatic breast cancer arises months or years after a person has completed treatment for early or locally advanced breast cancer. This is sometimes called a distant recurrence.
Some people have metastatic breast cancer when they are first diagnosed . This is called de novo metastatic breast cancer.
Komen Perspectives
What Is Metastatic Breast Cancer
Metastasis is the process by which cancer cells spread. In the case of metastatic breast cancer, the cancer originated in breast tissue, then spread to other parts of the body.
Metastatic cancer is further described as local, regional or distant, depending on the location of the cancer cells in relation to the original tumor.
- Localized metastatic breast cancer often means the breast cancer has spread to nearby lymph nodes.
- The more distant locations include the bones, lungs, skin, liver and brain, although its possible for other parts of the body to be affected.
Its important to remember that every cancer is unique and that your experience may not necessarily be the same as that of another breast cancer patient. With a personalized treatment plan, metastatic breast cancer is typically treatable. A recent National Cancer Institute study found that the number of U.S. women living longer with distant metastatic breast cancer is growing, thanks to advances in treatments.
Its also important to prepare yourself with information about the disease, its symptoms and how its detected and treated.
This article will cover:
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How Effective Are Treatments For Metastatic Breast Cancer In Bones
Treatment for bone metastasis can effectively manage metastatic breast cancer for some time. Many people with bone metastasis continue to have a good quality of life and live for many years. That said, treatment for metastatic cancer doesnt usually eliminate all cancer cells, and eventually, these cells become resistant to therapy.
According to the , the 5-year survival rate for metastatic breast cancer is 28 percent for women and 22 percent for men. Its important to note that cancer survival statistics are based on people who were diagnosed and treated at least 5 years ago. That means they dont reflect the effectiveness of the newest treatments and treatments are improving every year.
Its also worth noting that survival rates for metastatic cancer are very diverse and dependent on the individual and the type of cancer they have. For example, people with hormone-receptor positive cancers and HER2-positive breast cancers may do well for a long time, compared to those with triple-negative breast cancers. So, lumping all forms of metastatic cancer into one statistic can be misleading.
Regardless of the type of breast cancer you have, early diagnosis and treatment are crucial, as survival rates are higher in the early stages of breast cancer. And remember, the right treatment for stage 4 breast cancer can improve quality of life and longevity.
Surgery Of The Bone/radiotherapy
If a fracture of the bone has occurred or is likely to occur, then an orthopedic assessment is necessary to determine if a surgical intervention is needed before RT or RT alone is adequate. In emergent cases where a spinal compression has occurred, surgical decompression is the optimal treatment of choice. If surgery is not feasible, then an emergent RT is also an option .
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Breast Cancer Metastasis To Skin Survival Rate
Life expectancy is only 6 weeks for the patient if breast cancer spread to lymph nodes. The pain in the chest and internal part of it is really worse and that is the reason it has that much of a short life expectancy.
There are rare chances of metastasis breast cancer to spread into skin. But it is possible through the blood and lymphatic system. The scalp, neck, abdomen, back and upper limbs are some common areas of skin which may be affected by metastasis breast cancer.
Skin cancer can change the idea of living quality life for most of the womens. If a breast cancer is visible from the outside of the particular area women can grow low self esteem towards life. Appearance is really more important for women than men.
How Can I Take Care Of Myself While Living With Metastatic Breast Cancer
Living with metastatic breast cancer can be challenging. Your care team can help provide physical and emotional support. Talk to them about how you can:
- Eat the most nutritious diet for your needs.
- Exercise regularly.
- Get emotional support, including finding support groups.
- Reach out for help from friends, family and loved ones.
- Find mental health services.
- Find complementary therapies.
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