Breast Cancer Stage 4 Metastatic

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.

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

Genetic Risks Of Triple

The main demographics for triple-negative breast cancer diagnosis are younger women , African-American and Hispanic women, and people with a BRCA1 mutation. About 15% to 20% of women with a triple-negative breast cancer prognosis have a genetic mutation. That means these women are at risk for other cancers and their family members could be at risk for cancers as well. Our team encourages women to talk with their providers about genetic counseling and testing.

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Are There Any Statistics On Recurrence Rates Or Incidence Of Metastasis

As mentioned, it is very difficult to find statistics on metastatic breast cancer that has recurred after initial diagnosis. However, these cases represent a large proportion of Stage IV breast cancer cases and overall deaths.

Most of the statistical data on Stage IV or metastatic breast cancer is from those women presenting at diagnosis. According to the Metastatic Breast Cancer Network in 2012 new cases of Stage IV breast cancer were between 13,776 to 22,096.

The number of breast cancer recurrences at Stage IV is estimated to be between 20% and 30% of all breast cancer diagnoses.

How Having Metastatic From The Start Might Influence Treatment

There are some advantages for women diagnosed with de novo metastatic breast cancer compared to women who have progressed following an early breast cancer. The main advantage is that their cancer is treatment naïve, meaning it has not previously been exposed to any anti-cancer treatments and is therefore likely to be more responsive to treatment. There have been some reports of small numbers of women who may even be cured from metastatic breast cancer in this circumstance. In addition, there are more treatment options available than for those who have received previous treatment for early breast cancer who may have already used up some of their options.

The one positive was that my oncologist said that he more or less had an open book of treatments that he could offer me.

Another positive that women sometimes describe is that they can feel the cancer in their breast getting smaller once treatments starts. Mammograms and breast ultrasounds may be used as a way of checking that the cancer in the breast is responding to treatment. Many women find this reassuring, knowing that the treatment they are having is working for them.

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How Life Expectancy And Relapse Differ From Positive Tumors

Questions about the survival rate and recurrence rate are very common when someone is diagnosed with triple-negative breast cancer. While prognosis is, on average, poorer than with hormone receptor or human epidermal growth factor receptor 2 positive tumors, triple-negative breast cancer is a very diverse disease.

On a positive note, and unlike hormone-positive tumors that commonly recur late , late recurrence is less common with triple-negative tumors. The recent approval of immunotherapy only for triple-negative disease is also optimistic.

This article looks at factors that may affect survival or recurrence of triple-negative breast cancer, as well as the statistical rates of both. It also discusses life expectancy with stage 4 and recent case reports of some longtime survivors.

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What Is The Prognosis For Stage Iv Breast Cancer

Whether a patients metastatic breast cancer is the oligometastatic type or the most challenging, widespread sort, the best possible care addresses the patient as a unique individual. And according to Habibi, there are more reasons for hope than ever before.

Advancements in treatment options have extended the survival of patients with metastatic breast cancer, which had a stigma of being untreatable just a generation ago.

Even within the last decade, all aspects of care have seen a good amount of progress. Better diagnostic tests such as improved PET and CT scans are helping us find cancers faster and initiate treatment. And targeted therapies such as radiation, surgery and systemic treatments have seen improvements as well.

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Survival Rates And Prognosis

The outlook for breast cancer is often described in terms of relative survival rates.

Relative survival rates are an estimate of the percentage of people who will survive their cancer for a given period of time after diagnosis. Survival among people with cancer is compared to survival among people of the same age and race who have not been diagnosed with cancer.

Five-year relative survival rates tend to be lower for triple-negative breast cancer than for other forms of breast cancer.

According to the American Cancer Society, the overall 5-year relative survival rate for TNBC is . However, an individuals outlook depends on many factors, including the stage of the cancer and the grade of the tumor.

Your healthcare professional will be able to give you a more precise outlook based on:

• the stage of your TNBC

How Is Metastatic Breast Cancer Treated

The main treatment for metastatic breast cancer is systemic therapy. These therapies treat the entire body. Systemic treatments may include a combination of:

Your care team will plan your treatment based on:

• Body parts cancer has reached.
• Past breast cancer treatments.
• Tumor biology, or how the cancer cells look and behave.

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Treatments For Metastatic Triple

One myth about treating TNBC is that there arent effective treatment options. The truth is that an array of treatments can improve your care. Your treatment options include many medicines and may also include targeted therapies that treat some triple-negative breast cancers with specific features.

How do you choose from the many available chemotherapy options? It is important to talk with your doctors about how you wish to balance the goals of keeping the cancer under control as long as possible and maintaining your ,or overall enjoyment of life.

Another important point about treating metastatic TNBC is that if you had early- disease, you can retry medicines you were treated with before. A certain treatment may have failed to get rid of the primary disease, but that treatment could still control it in the metastatic setting.

Common chemotherapy treatments for metastatic triple-negative disease are:

• , which kill cancer cells by stopping growth. Three anthracyclines used in metastatic breast cancer are:

Symptoms Of Metastasis May Vary Depending On Where The Cancer Has Spread To

Here are some symptoms that vary by locations commonly associated with breast cancer metastasis.

Metastasis in the bone may cause:

• Severe, progressive pain
• Bones that are more easily fractured or broken

Metastasis to the brain may cause:

• Persistent, progressively worsening headache or pressure to the head
• Vision disturbances
• Behavioral changes or personality changes

Metastasis to the liver may cause:

• Abnormally high enzymes in the liver
• Abdominal pain, appetite loss, nausea, and vomiting

Metastasis to the lungs may cause:

• Chronic cough or inability to get a full breath
• Abnormal chest X-ray
• Other nonspecific systemic symptoms of metastatic breast cancer can include fatigue, weight loss, and poor appetite, but its important to remember these can also be caused by medication or depression.

If you notice these symptoms, be sure you talk with your physician. They could be important for getting the treatment you need.

Interested in learning more? i3Health is hosting an upcoming webinar Metastatic Triple-Negative Breast Cancer: Applying Treatment Advances to Personalized Care. Learn more here.

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What Are The Chances Of Breast Cancer Recurring

Despite huge advancements in breast cancer screening, early detection and treatment, a percentage of breast cancers will recur and spread to distant sites.

Although at the moment, it is almost impossible to say which cancers will recur and at what time period from diagnosis, there are a few factors that are known to increase the risk for recurrence.

These risk factors include:-

• Lymph node involvement and number of lymph nodes affected at the time of diagnosis
• Tumor Size at the time of diagnosis
• A subtype of Breast Cancer and hormonal receptor Status
• The time span from the initial diagnosis to recurrence of breast cancer

Facts You Should Know About Triple

• Triple-negative breast cancer is an uncommon kind of breast cancer in which the cancer cells test negative for three common markers, the estrogen receptor , progesterone receptor , and a protein involved in cell growth known as HER2.
• The triple-negative status of a cancer means that anti-hormonal therapies and therapies targeted against the HER2 protein are not effective.
• About 10%-20% of all breast cancers are triple-negative.
• Doctors usually treat triple-negative breast cancers with surgery, chemotherapy, and in many cases, radiation therapy.
• Triple-negative cancers have a more aggressive course than other breast cancers and are more likely to recur over the first few years after diagnosis. After 5 years, the likelihood of recurrence decreases.
• A majority of cases of breast cancer in women with a BRCA-1 mutation are triple-negative.

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Recurrence Of Metastatic Breast Cancer

Metastatic breast cancer is considered a chronic disease, so it doesnt go away and recur.

But in recent years, people under age 50 have seen a particularly strong decline in death rates due to breast cancer, according to the Centers for Disease Control and Prevention .

These declines are due in part to improved screening and treatment for the disease.

There are a few general facts that are helpful to know about breast cancer outlook:

• Breast cancer is the most common cancer diagnosis in the United States, according to the

Living With Metastatic Breast Cancer

It can be upsetting for you, your family, and other loved ones to learn that breast cancer has spread to other areas of the body. But there are ways to manage your feelings, get support, figure out how to talk about the diagnosis with family and friends, and work after being diagnosed.

Its not always easy to balance your sexual needs with the physical and emotional challenges of a metastatic breast cancer diagnosis. You can manage the sexual issues that can often come up with a metastatic breast cancer diagnosis.

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Types Of Breast Cancer

There are several types of breast cancer, and any of them can metastasize. Most breast cancers start in the ducts or lobules and are called ductal carcinomas or lobular carcinomas:

• Ductal carcinoma. These cancers start in the cells lining the milk ducts and make up the majority of breast cancers.

• Lobular carcinoma. This is cancer that starts in the lobules, which are the small, tube-like structures that contain milk glands.

Some breast cancers are made up of a combination of types of breast cancers. These are sometimes called invasive mammary cancers.

Breast cancer can develop in women and men. However, male breast cancer is rare. Less than 1% of all breast cancers develop in men.

How Is Metastatic Breast Cancer Diagnosed

If you have symptoms of metastatic breast cancer, your provider may recommend tests including:

• Blood tests, including complete blood count and comprehensive metabolic panel.
• Imaging studies, including MRI, CT, bone scan and PET.
• Bronchoscopy, which uses a scope to look inside your lungs this can be done if there is a concerning spot in the lungs.
• Biopsy to remove tissue from a suspicious area and analyze it.
• A tap to remove fluid from an area with symptoms. For example, pleural tap removes fluid from the lung area. Spinal tap removes fluid from the spinal cord area.

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How Does Chemotherapy Work

Chemotherapy. Chemotherapy uses one or more drugs to kill cancer cells and slow cancer growth. The drugs are taken orally or intravenously. Afterward, they travel through the bloodstream. This way, the drugs can target the original site of the cancer as well as areas in the body where the cancer cells have spread.

Stage Iv Breast Cancer Treatment Options

• Breast Cancer Recurrence

With stage IV, the breast cancer has spread to other parts of your body. Often the bones, brain, lungs, or liver are affected. Because multiple areas may be involved, focused treatments like surgery or radiation alone may not be enough.

Treatment of stage IV doesnât cure the disease. But by shrinking the cancer, it can often slow it down, help you feel better, and let you live longer. Patients with stage IV breast cancer may live for years, but itâs usually life-threatening at some point.

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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.

A Disease No One Gets

Sadly, people donât âgetâ mets. In fact, a recent survey sponsored by Pfizer Oncology shows just how misunderstood it is. Sixty percent of the 2,000 people surveyed knew little to nothing about MBC while 72 percent believed advanced breast cancer was curable as long as it was diagnosed early. Even more disheartening, a full 50 percent thought breast cancer progressed because patients either didnât take the right treatment or the right preventive measures.

âTheyâve built an industry built on four words â early detection equals cure â and that doesnât even begin to define breast cancer,â said Schoger, who helped found Breast Cancer Social Media, a virtual community for breast cancer patients, caregivers, surgeons, oncologists and others. âWomen are blamed for the fate of bad biology.â

The MBC Alliance, a consortium of 29 cancer organizations including the biggest names in breast cancer , addressed this lack of understanding and support as well as what many patient advocates term the underfunding of MBC research in a recently published landmark report.

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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.

Looking For More Of An Introduction

If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net:

• ASCO AnswersFact Sheet: Read a 1-page fact sheet that offers an introduction to metastatic breast cancer. This free fact sheet is available as a PDF, so it is easy to print.

• ASCO AnswersGuide:Get this free 52-page booklet that helps you better understand breast cancer and its treatment options. The booklet is available as a PDF, so it is easy to print.

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Plans Have To Be Flexible

My energy is unpredictable, says Sendelbach. I literally never know how Im going to feel from one day to the next. Its so hard to make plans because if I say yes to something thats two weeks away, the day of, I could wake up and feel absolutely horrible.

When someone with metastatic breast cancer declines an invitation or cancels at the last minute, its most likely not because they dont want to be there. Says Sendelbach, We physically cant do it.

Silberman agrees. Ive been going through for a long time, she says, and Ive had friends drop away. Because of MBC and my treatments, its hard for me to be reliable.

What Is Metastatic Cancer

Cancer that spreads from where it started to a distant part of the body is called metastatic cancer. For many types of cancer, it is also called stage IV cancer. The process by which cancer cells spread to other parts of the body is called metastasis.

When observed under a microscope and tested in other ways, metastatic cancer cells have features like that of the primary cancer and not like the cells in the place where the metastatic cancer is found. This is how doctors can tell that it is cancer that has spread from another part of the body.

Metastatic cancer has the same name as the primary cancer. For example, breast cancer that spreads to the lung is called metastatic breast cancer, not lung cancer. It is treated as stage IV breast cancer, not as lung cancer.

Sometimes when people are diagnosed with metastatic cancer, doctors cannot tell where it started. This type of cancer is called cancer of unknown primary origin, or CUP. See the Carcinoma of Unknown Primary page for more information.

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