Diagnosing Metastatic Breast Cancer
To diagnose metastatic breast cancer, your doctor may recommend one or more tests:
- A complete blood count to assess your bone marrow function
- Tests for minerals and enzymes that can provide evidence of spreading cancer or other health conditions
- Tests for proteins that signal the presence of cancer
Newly Diagnosed Or Worried About A Symptom
In the days or weeks after a diagnosis of secondary breast cancer, you may feel in turmoil and find it hard to think clearly.
You can read our information for people newly diagnosed with secondary breast cancer, including where to find support.
If you havent been diagnosed but are worried about a symptom, find out more about the signs and symptoms of secondary breast cancer.
Support For Living With Secondary Breast Cancer In The Liver
Everyones experience of being diagnosed with secondary breast cancer is different, and people cope in their own way.
For many people, uncertainty can be the hardest part of living with secondary breast cancer.
You may find it helpful to talk to someone else whos had a diagnosis of secondary breast cancer.
- Chat to other people living with secondary breast cancer on our online Forum.
- Meet other women with a secondary diagnosis and get information and support at a Living with Secondary Breast Cancer meet-up.
- Live Chat is a weekly private chat room where you can talk about whatevers on your mind.
You can also call Breast Cancer Nows Helpline free on 0808 800 6000.
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Will I Need More Than One Treatment For Metastatic Breast Cancer
Medications are important for metastatic breast cancer to help control its spread. Resistance to therapies may develop, which can lead your care team to recommend a change in treatment.
When you start a treatment regimen, you and your care team will see how:
- The cancer responds to the therapy.
- The side effects impact you.
If the treatment isnt working or the side effects are unbearable, your care team can discuss switching the treatment method. They may recommend a different drug, dosage or schedule.
There are many treatments available. If one therapy isnt working for you for whatever reason, there is usually another one you can try.
For Family And Friends
Caring for a loved one with stage 4 breast cancer has special challenges as well. Fortunately, organizations such as CancerCare now offer support groups design for loved ones who are caring for someone with cancer. In addition to caring for yourself , it’s helpful to learn about metastatic breast cancer.
Common things that people learn about cancer usually refer to an early-stage disease, and myths about metastatic breast cancer can be painful for those living with advanced disease. For example, one of the things not to say to someone with metastatic breast cancer is, “When will you be done with treatment?”
For the most part, people with metastatic breast cancer will require some type of treatment for the rest of their lives.
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Aggressive And Advanced Metastatic Breast Cancer
Habibi says the most extreme situations involve patients who are diagnosed with a very fast, aggressive breast cancer that has already spread to multiple organs and begins to overwhelm the body. For those patients, palliative care is important, concentrating on local control, pain management and avoiding bleeding and infection.
Breast Cancer Metastasis To Liver
When cancer spreads to the liver, it is called “secondary liver cancer.” It is also referred to by the same name as the original cancer. Breast cancer that has spread to the liver is known as, breast cancer metastasis to liver and will always be known as breast cancer. This is because the cancer cells that are found in the liver are still composed of breast cells. This is why it is different from primary liver cancer. This article explains how and when breast cancer spreads to the liver and what can be done to slow the progression.
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Can Stage 4 Breast Cancer Go Into Remission
Stage 4 breast cancer can go into remission, meaning that it isnt detected in imaging or other tests. Pathological complete remission indicates a lack of cancer cells in tissues removed after surgery or biopsy.
But its rare to take tissue samples while treating stage 4 breast cancer. This could mean that although treatment has been effective, it hasnt completely destroyed the cancer.
Advances in stage 4 breast cancer treatments are helping to increase the length of remission.
Poor Appetite And Weight Loss
Sometimes people with secondary breast cancer cannot eat as much as usual. This means they may have difficulty maintaining their weight as well as providing the body with energy.
Poor appetite can be due to the effects of the cancer, treatment or anxiety. You might find it easier to eat little and often instead of having set meals. If you still feel youre not eating enough, or are losing weight, talk to your doctor or nurse about dietary supplements or ask to speak to a dietician for specialist advice. In some circumstances you may be prescribed medication to help stimulate your appetite.
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How To Handle Emotions
Coping with the many symptoms that can occur with stage 4 breast cancer can be frustrating and discouraging, and people sometimes wonder if they will have to feel poorly the rest of their lives. Anxiety and depression are also severe for some people with advanced disease.
Fortunately, palliative care team consults are now offered at many cancer centers. While hospice is a form of palliative care, palliative care can be helpful even with early, curable tumors. Working with a palliative care team to address physical and emotional issues frees you up to work with your oncologist on issues that treat your cancer specifically.
While the research is also young, it appears that those people who receive palliative care consults not only have a better quality of life with advanced cancer, but they may actually live longer, too.
Is Stage 4 Breast Cancer Curable
Theres currently no cure for stage 4 breast cancer, but with treatments it can be kept under control, often for years at a time.
People with metastatic breast cancer need to receive treatments for the rest of their lives. If a certain treatment stops being effective, another treatment regimen may be tried.
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Forms Of Prognostic Scoring
Another way to predict overall outcomes for cancers is through prognostic Scoring. The prognosis for small-cell lung cancer can be done through Manchester score.
International Prognostic Index is used for prognosis of a condition like Non-Hodgkin lymphoma. There are also certain other conditions where prognostic indicators are used like Drug mediated Liver Dysfunctions and exercise stress test after myocardial infarction. Prognostic indicators are also used to predict the overall outcome of patients with multiple myeloma.
What Are The Symptoms Of Metastatic Cancer
The symptoms produced by metastatic breast cancer vary depending on the location of the metastases.
For example, metastatic disease to the bone causes severe, progressive pain, and less commonly, pathological fracture, erythema over the affected bone and swelling.
Breast cancer cells that have spread to the brain cause persistent, progressively worsening headache, visual changes, seizures, nausea, vomiting, vertigo, behavioral and personality changes and increased intracranial pressure.
Metastatic disease to the liver causes jaundice, elevated liver enzymes, abdominal pain, loss of appetite, nausea, and vomiting.
Metastatic breast cancer to the lung or pleura causes chronic cough, dyspnea, abnormal chest x-ray, and chest pain.
In addition, general, non-specific systemic symptoms of metastatic breast cancer include fatigue, malaise, weight loss and poor appetite.
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Treatments For Breast Cancer Metastasis To Liver
When you get the news that breast cancer metastasis to liver is incurable you may go through a range of emotions. When breast cancer is only in the breast tissue or the lymph nodes in your armpit a cure is highly possible. Once cancer spreads beyond those areas, it is no longer curable. However, you can still receive treatment to slow the progression of the cancer.
Doctors usually focus treatment on extending life and increasing the quality in which you live. When determining treatment, they look at the following:
- Your past treatments
- How the cancer cells look
- Extent of metastasis
- Hormone receptor sensitivity
If your cancer cells are positive for hormone receptor sensitivity, they can give you hormone therapy treatments to trick the cancer cells into dying.
They can also do more rounds of chemotherapy and radiation to shrink any tumors and slow their growth. These treatments may also help reduce your symptoms. New symptoms may develop from side-effects of the treatments.
The side-effects of treatments include nausea, vomiting, anemia, loss of appetite, weight loss, and lowered immune response. Side-effects are treatable in order to continue aggressive therapy.
Response to Treatment
To combat this from happening, doctors will monitor the response to treatments. If resistance occurs, they can switch drugs. They can also head this off by switching drugs in the very beginning of treatment for metastasis.
When Do People Get A Metastatic Breast Cancer Diagnosis
Metastatic breast cancer can occur at different points:
- De novo metastatic breast cancer: About 6% of women and 9% of men have metastatic breast cancer when theyre first diagnosed with breast cancer.
- Distant recurrence: Most commonly, metastatic breast cancer is diagnosed after the original breast cancer treatment. A recurrence refers to the cancer coming back and spreading to a different part of the body, which can happen even years after the original diagnosis and treatment.
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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:-
- Bone: .
What You Need To Know
- Metastatic breast cancer is serious, but the diagnosis does not always mean the end of life.
- The most common place for breast cancer to spread is to the bones. The liver and the lungs are other areas where breast cancer can metastasize.
- In about 15% of cases, metastatic breast cancer can be detected at the time of diagnosis. It can affect people who had breast cancer without seeking treatments, patients with aggressive breast cancer types and those with breast cancer not detected by screening.
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Liver Resections Of Isolated Liver Metastasis In Breast Cancer: Results And Possible Prognostic Factors
1Department of General, Thoracic, Vascular and Transplantation Surgery, University Hospital Rostock, Schillingallee 35, 18057 Rostock, Germany
2Department of General, Visceral, Vascular and Paediatric Surgery, University Hospital of the Saarland, Kirrberger Straße, 66424 Homburg/Saar, Germany
3Department of Medical Statistics, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
Metastasis is the most common cause of death in cancer patients . Breast cancer might spread via blood stream and cause liver metastasis. This can arise simultaneously or decades after the primary tumour. Metastases are often the sole sign of recurrence of the breast cancer. References show that 212% of patients with breast cancer have liver metastasis , which, however, might be isolated in some cases. In patients with resectable colorectal liver metastasis, surgical resection is the only curative approach, if an additional nonresectable extrahepatic tumour is excluded. References report 5-year survival rates of 30 to 47% in these patients . Surgical management is therefore recommended in the German S3-guidelines for colorectal cancer . In contrast to this the data on isolated liver metastasis in breast cancer patients is not as explicit.
2. Patients and Methods
Risk Stratification And Survival
According to prognostic scores derived from regression coefficients, patients were stratified into three risk groups . X-tile software was adopted to determine the optimal cutoff value of risk stratification, including low- , intermediate- , and high-risk groups . Intermediate- and high-risk groups had significantly worse prognosis in comparison with the low-risk group . In the validation set of 307 patients, intermediate- and high-risk groups were also related with significantly increased death risk compared with the low-risk group, showing the strong ability for discrimination in our prognostic model . The median OS of three groups were 39.97, 21.03, and 8.80 months with the 3 year OS rates of 54, 25, and 1%, respectively.
Table 3. Calculation of the score and cutoff points of the prognostic groups.
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Mechanisms Of Breast Cancer Metastasis
No one really knows what factors will make a certain patient more or less susceptible to breast cancer metastasis.
There is growing awareness that part of that susceptibility is due to host factors. The host factors are the characteristics of the non-malignant cells and the general biological environment surrounding the malignant breast tumor.
Sometimes the host factors are referred to as the pre-metastatic niche and it is thought that bone-marrow-derived progenitor cells may directly influence the dissemination of malignant cells to distant areas.
Non-neoplastichost cells within the tumor may also play a key role in the regulation of breast cancer metastasis.
Risks/chances Of Breast Cancer Metastasis To Liver
There are a slight number of cases early in cancer diagnosis that already have breast cancer metastasis to the liver. The number totals around less than 5 percent of all breast cancer diagnoses. In cases of early breast cancer that is still only in breast tissue, risk increases depending on the person, health status, and time after cancer treatment.
If you have been diagnosed with breast cancer metastases, there will be some increased challenges in treating and slowing the progression. It depends on the stage of cancer, the treatment, and time since diagnosis.
Metastasis occurs when the cancer has spread to the lymph nodes and hitches a ride into other organs. At first, the cancer goes into the lymph nodes near the armpit “axillary lymph nodes.” At this stage, there is a possibility of curing the cancer. If the cancer moves beyond the axillary lymph nodes, there is no cure but it is treatable.
Path of Breast Cancer Spreading to the Liver
Breast cancer spreading into your liver takes a certain path in stages. These are:
- Invasion of Local Tissue
The cancer cells invade the local breast tissue and form tumors. The cells then grow into tissue around the breasts. It begins to take over all the healthy tissue in the area. The cancer moves outside of the breast tissue or “margins.”
- Lymph Node Invasion
- Arrest and Invasion of Liver
- Growth of Tumors
- Growth of Blood Supply
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How Do Breast Cancer Cells Spread Around The Body
Breast cancer cells travel through the body like any other cancer cells. Firstly, cancer cells can invade neighbouring healthy tissue. Following this, the cancer cells then invade local lymph nodes or blood vessels.
When breast cancer spreads to the axillary lymph nodes this is still a relatively early stage of metastasis, and potentially curable.
The cancer cells will typically travel through the lymphatic system or blood vessels to other distant parts of the body.
Colorectal Cancer Liver Metastases
Liver metastasis from colorectal cancer has a maximum survival rate of an average of 6 months to 1.5 years, if left untreated. A two-year survival rate is not common and five-year survival rate is very rare. Factors associated with a significant disadvantage in the unresected group include the extent of liver disease, the presence of extrahepatic disease, the age of the patient, and carcinoembryonic antigen level. Though most patients with colorectal liver metastases have a poor prognosis, some patients can still benefit from radical surgery and possibly even avoid recurrence.
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Expert Review And References
- Alexander HR Jr, Berlin J, Moeslein F. Metastatic cancer to the liver. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins 2011: 149:2177-2191.
- BC Cancer Agency . Cancer Management Guidelines: Secondary Neoplasms of the Liver. BC Cancer Agency 2006: .
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:
- your age
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Intrahepatic Chemotherapy And Chemoembolisation
Intrahepatic chemotherapy and chemoembolisation involve giving chemotherapy directly into the liver. This is done through a thin tube, called a catheter, into the main blood supply to the liver.
Giving chemotherapy directly into the liver means a higher concentration of the drug can be delivered to the area of cancer.
In chemoembolisation, the chemotherapy is delivered along with an oily liquid or foam which blocks the blood supply to the cancer. The cancer is deprived of oxygen and nutrients, and the chemotherapy stays in the area for longer. The liver continues to be supplied with blood in the normal way.
These treatments may not be routinely available on the NHS but may be offered as part of a clinical trial.