Treatment Options For Stage Iv Breast Cancer
For women with stage IV breast cancer, systemic therapies are the main treatments. These may include:
- Some combination of these
Treatment can often shrink tumors , improve symptoms, and help women live longer. These cancers are considered incurable.
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Cancer In The Tissue Around The Brain And Spinal Cord
Sometimes breast cancer spreads to tissues and fluid that surround the brain and spinal cord. This is known as leptomeningeal metastases.
Symptoms are similar to those of secondary breast cancer in the brain, but may be less obvious and more difficult to diagnose.
Its usually diagnosed using an MRI scan, but you may also have a lumbar puncture to take a sample of fluid to be looked at under a microscope.
Treatment can include steroids, radiotherapy and chemotherapy. Chemotherapy or targeted therapy drugs may be given directly into the fluid surrounding the brain and spinal cord to treat the cancer.
What Is Metastatic Cancer
In metastasis, cancer cells break away from where they first formed , travel through the blood or lymph system, and form new tumors in other parts of the body. The metastatic tumor is the same type of cancer as the primary tumor.
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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I Am Sorry To Hear Of Your
I am sorry to hear of your diagnosis. Are you getting treatment? Do not listen to the numbers, a friend of my moms had breast cancer that spread to bones 12 years ago, she is still her getting regular maintenance treatments and leading a fairly normal life.
They are finally doing brain MRI today Oncologist said he would leave it up to the neurologist to decide whether to test spinal fluid…I’m thinking DO IT!! All other body scans are good so tackle all of the central nervous system instead of waiting for the next shoe to drop.
Mom’s was detected in her thoratic spine 3/31, she had radiation for that and the tumor is gone, I guess if it is in the fluid it is a whole different game.
My best to you, thanks for your post…
Palliative And Supportive Care
Palliative and supportive care focuses on symptom control and support.
Its extremely important for many people 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 supportive care teams are based in hospitals, hospices and the community. Your treatment team, GP or breast care nurse can refer you depending on your situation.
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Breast Cancer Brain Metastasis
The American Cancer Society predicts that in 2013, there will be approximately 40,000 breast cancer deaths in the United States. This mortality stems from the primary breast cancer metastasizing to a secondary vital organ, such as the lung, bone and brain. A plausible explanation for the development of metastasis is that migrating breast cancer cells extravasate into the circulatory system, and are detectable as circulatory tumor cells . Ultimately, select cells either possess or develop the ability to colonize the brain after intravasating across the blood brain barrier . If these breast tumor cells can adapt to the brain’s unique molecular and cellular microenvironment and continue to survive and proliferate, the patient will develop detectable metastases. Currently, the treatments for breast to brain metastasis are palliative with a median survival of a maximum of 16 mo. Importantly, the incidence of breast to brain metastasis has recently increased due to the improved systemic treatments of primary and non-brain metastatic breast cancer extending patient lifespan, particularly in patients with HER2-overexpressing and triple negative breast cancers.-
Routes of metastasis. Cancer cells can utilize the circulation system as well as lymph nodes to reach a distant organ and form a metastasis. The two routes, lymphatic route and hematogenous route , are depicted above.
Cancer Spread To Brain Lining And Spinal Fluid
|Jun 15, 2010 – 12:51 pm|
Hello, I am usually on LC site, mom has SCLC w/mets to brain and spine. Brain and spine tumors have been treated with radiation very successfully. She has become weak and unable to stand, walk, roll over etc…..they have scanned entire body, all clean.
They are wanting to do MRI of brain lining as well as a spinal tap to check those locations. Does anyone have any experiences to share on this subject?
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Biology Of Her2+ Bcbrm
Extensive work in HER2+ animal models has provided potential explanations for why this subtype of breast cancer has a predilection for CNS recurrence and subsequent BrM. HER2, as an oncogene itself, may drive brain trophism, as HER2 induces a more mesenchymal state in breast cancer cells, increasing invasiveness and metastatic potential. Induced expression of HER2 in experimental models increases the size of BrM from intracardiac injections, and may alter the spatiotemporal growth of BrM within different brain regions toward favoring more posterior areas.,
Additional features of HER2+ BC may contribute to its predilection for BrM. Truncated glioma-associated oncogene homolog 1 is highly expressed in HER2+ BC and has been shown to increase the incidence of BrM. TGLI1 may also contribute to radioresistance by increasing stemness and creating a âmetastasis-friendlyâ microenvironment through activation of astrocytes. Fatty acid binding protein 7 is a lipid binding protein found specifically in the brain. However, FABP-7 is also expressed in BC cells, particularly in HER2+ cells and in BrM. FABP7 is thought to induce a more glycolytic, metastatic, and pro-angiogenic state in BC cells, thereby enhancing the survival of HER2+ BC in the foreign brain microenvironment. Thus, beyond just HER2 expression and its interaction with other receptors, other aspects of HER2+ BC biology likely contribute to the brain metastatic potential of this subtype.
What Is Stage Iv Breast Cancer
Stage IV is the most advanced stage of breast cancer. It has spread to nearby lymph nodes and to distant parts of the body beyond the breast. This means it possibly involves your organs such as the lungs, liver, or brain or your bones.
Breast cancer may be stage IV when it is first diagnosed, or it can be a recurrence of a previous breast cancer that has spread.
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About The Medical Reviewer
Dr. Lin is a medical oncologist specializing in the care of patients with all stages of breast cancer. Her research focuses upon improving the outcomes of people living with metastatic breast cancer, including a particular focus on the challenge of breast cancer brain metastases. She has led multiple clinical trials which have led to new treatment options for patients with breast cancer that has metastasized to the brain.Dr. Lin received her MD from Harvard Medical School in 1999. She completed her residency in internal medicine at Brigham and Women’s Hospital and went on to complete fellowships in medical oncology and hematology at Dana-Farber. In 2005, she joined the staff of Brigham and Women’s and Dana-Farber, where she is a medical oncologist and clinical investigator in the Breast Oncology Center.
What To Know About Breast Cancer Growth
Breast cancer occurs when normal cells mutate and multiply faster than usual. One cell divides to become two cells, then each of those cells divides to become four cells, and so on. The uncontrolled multiplication of cancer cells creates tumors within the breast tissue.
The speed at which a cancer progresses depends on the growth rate of the cancer cells. It is hard to estimate cancer growth because not all cancer cells multiply and divide at the same speed.
In most cases, breast cancer initially develops in either the milk ducts or the lobules, which are the glands that produce milk, before expanding into the breast tissue.
Breast cancer that develops in ducts or lobules can spread to the connective tissue. From there, it can spread to the surrounding lymph nodes.
Once in the lymph nodes, the cancer cells can enter the lymphatic system or the bloodstream, where they can move to other areas of the body.
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I Feel Extremely Sad To Read
I feel extremely sad to read of all these cases. My mum fought breast cancer in 2008 and had a masectomy and underwent Chemo then in may this year she had extreme headaches and learned she had a brain tumor and had it removed and had radiotherapy, then around 2 months ago she had more pain so she had a few scans done and realized she had cancer in the lining of her brain, they said there’s not much more they can do and worst case she has 2 months left. It has now been nearly 2 months and she is getting worse everyday. She’s 52 years old and before this was so healthy and full of life. My now husband and I had planned to get married in oct 2012 but after we found out mum was terminal we brought the wedding forward and planned it in 3 weeks. We got married 2 weeks ago and mum was feeling pretty good and enjoyed every bit of the day, especially walking me down the isle with my dad. The day couldn’t have been more perfect. Since then she has gotten worse and it is heart breaking. How is it possible to not have s cure for her illness? I’m angry, upset, frustrated, and extremely sad. Nobody wants to watch their beautiful mum get worse by the day and its not fair at all.
Why It Spreads And Recurs
You may be wondering why breast cancer cells travel at all. Or, why normal cells don’t spread around our bodies. Cancer cells differ from normal cells in many ways. One of these is that normal cells have what is known as “adhesion molecules.” These adhesion molecules act like glue and keep cells where they belong in a particular part of the body.
Normal cells also have “boundaries” or ways in which cells communicate with each other. This is like one country saying to another “you don’t belong here.” Cancer cells, in contrast, don’t respect these cellular communications, essentially ignoring the “fences” between different tissues.
Yet another confusing topic when talking about breast cancer spread is why it can happen years or even decades later. We know that, especially with estrogen receptor-positive breast cancers, cancer can seemingly disappear only to recur many years after the original tumor. Nobody is certain exactly how this happens, but there are theories about recurrence that suggest that some breast cancer cells are hardier than others and that these cancer “stem cells” are able to lie dormant even through treatment.
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I Am So Sorry To Hear About Your Mom
but I am thrilled to hear that she rallied for your special day and was able to enjoy it with you and the family.
As for the lining of the brain? Unless I am mistaken, that would be the meninges in which case the tumors could be meningiomas. I am very familiar with meningiomas as I have many snaking their way through my skull as well.
What I can tell you about them is that they work by compression rather than invasion . Mine have “compressed” their way into my eustacian tubes, around my carotid artery, left optic nerve, optic nerve chiasm and are also at the skull base.
Your mother’s tumors could be considered inoperable due to the location , how many she has , grade, size, etc.
As for the tumors on the spine, they may not feel that they can safely operate or have any further treatment options where the benefits outweigh the risks.
Another reason they may feel she is terminal is that her age, overall health condition, previous medical interventions could make her a bad candidate for any further treatment.
Please use the time left with your mom to let her know how important she is to you, what you have learned from her and what you hope everyone can learn from this experience. This is not an easy journey, unfortunately, it is one many of us have to face.
You’re in my prayers.
When Metastatic Cancer Can No Longer Be Controlled
If you have been told your cancer can no longer be controlled, you and your loved ones may want to discuss end-of-life care. Whether or not you choose to continue treatment to shrink the cancer or control its growth, you can always receive palliative care to control the symptoms of cancer and the side effects of treatment. Information on coping with and planning for end-of-life care is available in the Advanced Cancer section of this site.
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Breast Cancer That Has Spread To The Brain
This is known as secondary breast cancer in the brain. It can also be called brain metastases or brain mets.
Its not the same as having cancer that starts in the brain. The cancer cells that have spread to the brain are breast cancer cells.
For some people, the brain may be the only area of secondary breast cancer.
Therapeutic Development For Her2+ Bcbrm
The development of targeted therapies for both treatment and prevention of BrM in preclinical HER2+ BCBrM animal models has been extensive, ranging from small molecule inhibitors, to antibody-based strategies, to engineered cells under evaluation. Lapatinib, a small molecule inhibitor of EGFR and HER2, was the first HER2-targeting agent characterized in a model of BCBrM. Animals treated with a higher dose of lapatinib demonstrated significantly fewer large BrM after systemic inoculation of brain-seeking BC cells relative to vehicle-treated controls. Pazopanib demonstrated prevention potential against HER2+ BC brain micro- and macrometastases in preclinical models by reducing proliferation of tumor cells. Neratinib treatment completely prevented any BrM, large or small, in a spontaneous HER2+ BC mouse model with a high proclivity for spontaneous BrM. Newer HER2-targeting agents, such as TAK-285 and Epertinib , display improved efficacy over lapatinib, due in part to achieving higher concentrations in BrM., ,
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H& o How Common Are Brain Metastases
CA Lung cancer, melanoma, and breast cancer are the 3 types of cancers that are most likely to metastasize to the brain. Other solid-tumor cancers and some hematologic malignancies also can metastasize to the brain, but this occurs much less frequently. Brain metastases are common enough in advanced lung cancer that we order magnetic resonance imaging of the brain at initial presentation, whereas we proceed with intracranial imaging in advanced breast cancer only if patients have symptoms that are suggestive of brain metastases.
Across all subtypes, approximately 10% to 15% of women with metastatic breast cancer develop brain metastases. This rate is as high as 30% for women with advanced human epidermal growth factor receptor 2 -positive disease, and as high as 50% for women with metastatic triple-negative breast cancer.
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What Are The Major Risk Factors For Brain Metastasis
Scientists do not yet know why breast cancer is more likely to spread to some parts of the body than others, but some factors that increase the risk of spread to the brain have been identified:
- Being diagnosed with breast cancer while relatively young, particularly before age 35.
- Having a breast cancer that has already spread to the lungs.
- Certain subtypes of breast cancer, such as HER2-positive or triple-negative.