Stages Of Breast Cancer: Stage Iiic
Stage IIIc breast cancers basically involve tumors of any size with significant metastases to:-
- the lymph nodes behind the sternum
- lymph nodes under the arm
- the lymph nodes above or below the collarbone
The extent and depth of lymph node involvement make these patients unsuitable candidates for surgical treatment as a primary mode of therapy. Chemotherapy is the treatment of choice for women with stage IIIb and IIIc breast cancers.
However, up to 70% of patients with stage III breast cancers who have chemotherapy remain alive and disease-free after 7 years.
Risks And Side Effects Of Surgery
The short-term risks of any type of surgery include reactions to anesthesia, too much bleeding , blood clots, and infections. Most people will have at least some pain after the operation, which can usually be helped with pain medicines, if needed.
Other possible risks of surgery include:
- Damage to internal organs and blood vessels during surgery
- Pneumothorax
If Your Breast Cancer Has Spread
Even if your breast cancer has spread to other parts of your body, it does not necessarily mean its not treatable. If the cancer cannot be removed, the goal of treatment is to improve symptoms, improve quality of life and extend survival.
Some women live with breast cancer for several years as they learn to adjust and accept that theyll be on treatment for an indefinite period of time, explains Dr. Roesch. Your cancer team will help you learn and cope with what you can expect on this journey.
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Local Or Regional Treatments
The systemic therapies described above are the main treatments for metastatic breast cancer.
However, local and regional treatments, including radiation, surgery, and chemotherapy can also be used to help treat metastatic cancer in a specific part of the body, but theyre unlikely to completely eradicate it.
Usually, these therapies are used to treat symptoms or complications of the cancer.
For example, radiation and surgery may be used in these situations:
- when a breast tumor causes an open wound in the breast
- to treat a small number of metastases in a specific area, such as the brain
- to help prevent bone fractures
- when a tumor is pressing on the spinal cord
- to treat a blood vessel blockage in the liver
- to provide pain relief or to relieve other symptoms
Chemotherapy can also be delivered directly to a certain area , to help relieve symptoms or complications.
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.
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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
Multivariate Logistic Regression Results
We performed a raw logistic regression model with all variables from Table 1. Coefficients, standard errors, P values for each was calculated and documented in Table 2. Then we picked out significant variables including age, sex, histological type, N stage, grade, ER status, PR status and HER2 status. Afterwards, 1:1 randomly assigned training and validating groups was divided and we put these significant variables into another logistic model in the training group. It turned out that all variables selected presented with significant P value. Speaking of coefficients, sex was the most significant predictor, much more significant than any other. N0 and N1 stages had P values below 0.0001, N2 had P value 0.0004. HER2 positive also had P value below 0.0001. Age was another highly significant predictor whose P value was 0.0005. Comparatively, ER status and grade performed a little worse but still had P value below 0.05. This was the fundamental step for model construction for a well fitted regression model leaded to a useful and reliable predicting nomogram.
Table 3
| 0.0005 |
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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.
Most Common Places It Spreads
It’s still breast cancer, even if it’s in another organ. For example, if breast cancer spreads to your lungs, that doesn’t mean you have lung cancer. Although it can spread to any part of your body, there are certain places it’s most likely to go to, including the lymph nodes, bones, liver, lungs, and brain.
3
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How Do Breast Cancers Spread
Cancer cells break away from the primary tumor, entering the bloodstream or the lymphatic system. As large vessels narrow, cancer cells stop traveling and lodge themselves in a new area. Then they begin dividing and moving into surrounding tissue. The cancer cells take over the new area, crowding out healthy cells and forming a new tumor. Cancer cells are insidious because the new tumor can set up its own network of blood vessels to obtain nutrients for growth and further spread.
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A Model For Breast Cancer Liver Metastasis
An increasingly sophisticated understanding of breast cancer liver metastasis is emerging. It appears that BCLM is mainly associated with specific subtypes in patients with breast cancer however, no direct correlation between subtypes and BCLM has been found. By combining the knowledge from the extant research, we propose a model for breast cancer liver metastasis , as follows: intravasation: invasive breast cancer cells invade via the endothelium of a tumor blood vessel into the circulation circulation: breast cancer cells survive in the blood vessels and lack of cell-cell or cell-matrix attachments margination: CTCs arrest at the liver site by adhering to the sinusoidal endothelial cell via specific sets of adhesion molecules, such as cadherins, integrins, Ig-SF, and CD44 extravasation: the migrated breast cancer cells invade through the endothelial wall of sinusoidal endothelial cells, migrates, and finally proliferates in the liver and colonization: breast cancer cells survive and form a life-threatening macrometastatic focus in the liver microenvironment by mediating hypoxia-inducible factor-regulated genes , the status of ER, PR, and HER-2 expression, and angiogenesis for breast cancer cells.
Figure 1
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What Is Secondary Breast Cancer
Secondary breast cancer is when cancer cells from a cancer that started in the breast spread to other parts of the body. The cancer that started in the breast is called primary breast cancer.Secondary breast cancer is also called advanced breast cancer or metastatic breast cancer. The most common places for breast cancer to spread to are the:
Rarely, breast cancer may spread to other parts of the body, such as the bone marrow, ovaries or lining of the tummy which is called the peritoneum.
Breast cancer can spread to different parts of the body. This does not mean it will go to all these places.
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What Are The Signs That Breast Cancer Has Spread
You may have any of the following symptoms if cancer has spread to your liver:
- tiredness.
- discomfort or pain on the right side of your tummy where the liver is.
- feeling sick
- yellowing of the skin or itchy skin
Keeping this in consideration, where is the first place breast cancer spreads?
Breast Cancer Spreadscancer spreadsbreastmetastaticplacesspreads
What are the symptoms of breast cancer that has spread to the bones?
When it does occur, signs and symptoms of bone metastasis include:
- Bone pain.
- Bowel incontinence.
- Weakness in the legs or arms.
- High levels of calcium in the blood , which can cause nausea, vomiting, constipation and confusion.
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Characteristics Of Patients In The Three Groups
The 57 cases of UBCLM were randomly divided into three groups: HAIC/PVIC group, TACE group and TAE groups. The mean age of patients in each group was 55 , 52 and 51 years old, respectively. However, there were no significant differences in the clinicopathological characteristics of patients among these three groups .
What Are The Risk Factors
According to Research from 2015Trusted Source, the exact mechanics of how breast cancer spreads to the liver are still not known.
However, in one 2019 study, researchers found that a few distinguishing factors may place a person at higher risk of developing liver metastasis. These include:
- age
- number of lymph node metastases
- tumor size
Earlier or more frequent screening for liver metastasis may help improve outlook because a doctor may find the tumor sooner.
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What Happens When Metastatic Breast Cancer Affects Liver Know Symptoms And Treatment Options For This Disease
Metastatic Breast Cancer is a very severe cancer condition. Know what happens when tumour spreads to liver and infects it.
Cancer is considered one of the most severe medical conditions which has many side-effects and is hard to treat. There are different types of cancer which can occur in different body parts resulting to serious health issues. Breast cancer is another type of cancer that is more evident in women and results to loss of mammary glands and breast removal in some cases. Breast can has a sub-category called metastatic breast cancer which happens when the cancer spreads to the other parts of the body outside the breast such as liver. Today we will discuss the conditions that can occur when breast cancer affects liver of a person.
Does Metastatic Breast Cancer Affect Liver Often
Dr. Pooja says that reaching this stage of breast cancer was more common until treatment for cancer was available. After that in most cases, it is tried that patient does not come to a stage where the breast cancer starts spreading to other organs such as lungs. Spreading of cancer in liver can be especially problematic because it can affect your digestion and chances of recovery. This happens because liver purifies your blood which helps in recovery.
Fortunately, only 1 out of thousand cases that have breast cancer get their liver affected by this deadly disease. However doctor tells that it has not been proved that in general cases where breast cancer that has not spread to other parts can affect your liver function.
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When Can Metastatic Breast Cancer Occur
Some people have metastatic breast cancer when they are first diagnosed with breast cancer . This is called de novo metastatic breast cancer.
Most often, metastatic breast cancer arises years after a person has completed treatment for early or locally advanced breast cancer. This may be called a distant recurrence.
A diagnosis of metastatic breast cancer is not your fault. You did nothing to cause the cancer to spread.
Metastatic breast cancers come from breast cancer cells that remained in the body after treatment for early breast cancer. The breast cancer cells were always there but were dormant and could not be detected. For some unknown reason, the cancer cells began to grow again. This process is not well-understood.
How Do Breast Cancers Start
The human body is made of countless cells that reproduce, by splitting, to replace or repair other cells. New cells usually work like their parent cells. Sometimes, however, a new cell has an error. Not all cells with errors are bad some are harmless, or benign. Others, however, reproduce rapidly and harm healthy cells. The offensive cells are said to be malignant because they dont function like healthy parent cells.
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A Prognostic Model For Breast Cancer With Liver Metastasis
- 1Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China
- 2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- 3Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China
Background: Breast cancer with liver metastasis consists of a group of heterogeneous diseases, and survival time may be significantly different, ranging from a few months to several years. The present study aimed to develop and externally validate a prognostic model for breast cancer with liver metastasis .
Methods: In total, 1022 eligible patients from January 2007 to December 2018 were selected from Fudan University Shanghai Cancer Center and were temporally in the training and validation set. According to regression coefficients found in the multivariate Cox regression analysis, the final results were transformed into the prognostic scores. On the basis of these scores, patients were finally classified into three risk groups, including low-, intermediate-, and high-risk groups. Bootstrapping was used for internal validation. Then, time-dependent receiver operating characteristic curves and calibration plots were used to assess discrimination and calibration of this prognostic model in the validation set.
Symptoms Of Liver Metastases From Breast Cancer
When breast cancer spreads to the liver, it may not cause any symptoms. However, a variety of tests can help detect the presence of liver metastases, including liver function tests that measure enzyme activity in the liver which could reveal an abnormality prompting more extensive testing in the form of imaging. A liver function test is obtained from a simple blood sample and is very easy to measure. It is usually the first test patients obtain when suspicion of liver metastases exists.
Typical symptoms of liver metastases when they occur include
- Pain or discomfort in the mid-section
- Fatigue and weakness
- Weight loss and poor appetite
- Fever
- Swelling in the legs
- Jaundice, or a yellow tint to the skin or whites of the eyes
When present, these symptoms do not expressly point to liver cancer metastases from breast cancer as many other medical conditions can also cause them. This is why it is strongly recommended to be evaluated by a physician who is highly experienced in liver cancer.
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A Nomogram For Distinction And Potential Prediction Of Liver Metastasis In Breast Cancer Patients
Zhenhai Lin1*, Shican Yan2*, Jieyun Zhang 3*, Qi Pan1
1. Department of Hepatic Surgery, Fudan University Shanghai Cancer Center Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China2. Department of General Surgery, Huashan Hospital Shanghai Medical College, Fudan University, Shanghai 200040, P.R. China3. Department of Medical Oncology, Fudan University Shanghai Cancer Center Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China*These authors contributed equally to this work.
Corresponding author: Qi Pan, Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Address: Dong’an Rd 270, Shanghai 200032, China. E-mail: drpanqicom Tel: +86-21-18121299777.
Citation:J Cancer
Palliative And Supportive Care
Palliative and supportive care focuses on symptom control and support. Its an extremely important part of the care and treatment for many people living with secondary breast cancer and can significantly improve quality of life for them and their families.
People often associate palliative care with end-of-life treatment. However, many people value having it at any stage of their illness, alongside their medical treatment, to help prevent and relieve symptoms such as pain or fatigue. It can also help with the emotional, social and spiritual effects of secondary breast cancer.
The palliative and support care teams are based in hospitals, hospices and the community. You can be referred by your treatment team, GP or breast care nurse depending on your situation.
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Testing Lymph Nodes For Cancer
A swollen lymph node can be felt with your fingertips and sometimes, and if large enough, can be seen. However, there are other areas of the body where lymph nodes are more difficult to find and dont present symptoms on the surface. The only way to confirm a cancer diagnosis in the lymph nodes is through a biopsy.
A biopsy is performed by using a long, thin needle to remove part of the lymph nodes or lymphatic tissue and reviewing it under a microscope to see if there are cancerous cells. The number of cancer cells will determine the course of treatment. There are additional tests to also determine how far cancer has spread and the cancer stage. All of this plays a part in the type, frequency, and outlook of treatment.
If you are wondering, is cancer of the lymph nodes terminal, understand that cancer spreadto the lymph nodes does not automatically determine which stage its in.3 Typically, if its traveled far from its originating tumor source, it could indicate a later stage, though there are several tests that can be performed to get a clearer picture. These include:
Not all of these tests are necessary to confirm cancer staging, but they each help deliver more information to make an accurate diagnosis. Furthermore, cancer staging is assigned at the time of diagnosis but can be restaged following treatment. This is based on if cancer has stopped its growth or metastasized to other areas of the body.