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
I Have To Prioritize And Try Not To Sweat The Small Stuff
For Sendelbach, each week begins with a list of her priorities. Obviously, getting to my doctors appointments is very important, she says. But if the clothes arent folded, is that a dire situation? Absolutely not!
Sendelbach has learned to make compromises: If her husband and son have to pick up their clean clothes from the couch, she can live with that.
I have learned, she says, to look at every situation and ask if this is going to truly make a difference in my day or my familys day for better or worse. If the answer is no, then that task might be left undone.
It wasnt always this way for Sendelbach, though. When she was first diagnosed with cancer, her son was just a year old and she had been married for only two and a half years. You know how it is when you first have a baby if everything isnt perfect, then the world is falling apart! she laughs. Now, to us we ate, were all still alive, the house is acceptable if were good, its all okay.
Resources For Mbc Patients
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Riding The Psa Roller Coaster
Once Id read up on my options, I decided to hunt down the best doctors I could find. Im lucky in that I live just south of Boston, where there are major medical centers. I made appointment after appointment to get as many opinions as possible, before I landed on a Harvard Medical School-trained doctor who recommended hormone therapy, coupled with external beam radiationa combo plan that would reduce the size of the cancer to make it an easier target for the radiation.
On December 1, 2000, I started the hormone treatment between December 1, 2000, and January 31, 2001, they did the radiation.
Immediately after this treatment, things were looking good. My PSA levels dropped, which is what we wanted. When the prostate produces more PSA, it may indicate a problem, such as the potential development or growth of cancerso low is better. In fact, my numbers stayed lower for the next five years.
Then my PSA levels started to rise. The docs just wanted to keep an eye on it for a while. They were concerned, but not overly so. After a few months of this watchful waiting, my teama radiation oncologist, urologist and medical oncologisttold me I needed surgery to remove my prostate. And once again, I sat across from a urologist as he looked me straight in the eyes and said, I cant give you a cure, but I can give you a treatment.
How Can I Prevent Breast Cancer Recurrence
Healthcare providers dont know why some people experience breast cancer recurrence. A recurrence isnt your fault. You didnt do anything wrong to cause it or fail to do something more to prevent it.
Certain medications may reduce the risk of breast cancer recurrence in people who have early stage breast cancer. For estrogen-receptive breast cancer, hormonal therapies including tamoxifen or aromatase inhibitors block either the activity of estrogen or the bodys production of estrogen. Chemotherapy may also be recommended to reduce risk of breast cancer recurrence.
Early diagnosis may make it easier to treat a recurrence. Follow your healthcare providers recommendations for mammograms and other screenings. You should also perform regular breast self-exams. Get familiar with how your breasts look and feel so you can see your provider quickly if you notice changes. And remember that most breast changes occur for reasons other than cancer.
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What Are The Complications Of Breast Cancer Recurrence
Breast cancer that comes back can be harder to treat. The same therapy isnt always effective again. Tumors can develop a tolerance to certain treatments like chemotherapy. Your healthcare provider will try other therapies. You may be able to try drugs under development in clinical trials.
If breast cancer spreads to other parts of the body, your healthcare providers still treat it like breast cancer. For instance, breast cancer cells that move to the lungs cause breast cancer in the lungs not lung cancer. Metastatic breast cancer is more difficult to treat than cancer in only one part of the body.
Emotional And Spiritual Care
End-of-life care also includes emotional, mental, and spiritual therapy. A personâs healthcare team may include social workers, counselors, mental health professionals, and religious or spiritual advisors.
According to the Anxiety and Depression Association of America, up to 40 percent of people with cancer experience serious mental distress. This may include anxiety, depression, panic attacks, and post-traumatic stress disorder .
Medications, therapy, religious or spiritual rituals, and support groups can help a person cope with mental health issues and stress during this difficult time.
Caregivers may also need help with stress, anxiety, and depression. The palliative care team can usually also provide support and advice to caregivers for their emotional needs.
The Breast Cancer Healthline app provides people with access to an online breast cancer community, where users can connect with others and gain advice and support through group discussions.
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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.
Metastatic Breast Cancer: What You Should Know
What does it mean to have metastatic, or stage 4, breast cancer? A Rogel Cancer Center oncologist explains the diagnosis and how its treated.
After hearing a diagnosis of metastatic breast cancer, a rush of questions emerges. But often, its not until long after leaving the doctors office.
Metastatic means the cancer has spread beyond the breast and immediate lymph nodes to other organs or tissues in the body, most often the bones, brain, lungs or liver. Its considered stage 4 breast cancer, which means the cancer has progressed to its most advanced stage.
But even though its moved to other organs, it still behaves like breast cancer and is treated with breast cancer therapies.
More than 154,000 U.S. women are estimated to have metastatic breast cancer, according to the Susan G. Komen organization. Men can have metastatic breast cancer too, but its rare.
To help patients fill in information gaps, N. Lynn Henry, M.D., Ph.D., the breast oncology disease lead for the University of Michigan Rogel Cancer Center, explains the nuances of stage 4 metastatic breast cancer.
What are the differences between metastatic breast cancer, stage 4 breast cancer and advanced cancer?
If any doctor uses the term advanced, ask for clarification, Henry adds.
When does metastatic breast cancer appear?
What are the symptoms?
Symptoms of bone metastases:
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What To Do If You Have Breast Cancer
When you learn about such an unpleasant diagnosis, the first thing to do is to avoid panic in any way. Try to pull yourself together. After that, be sure to look for an experienced doctor who will tell you what to do and how to proceed. Only an experienced doctor will be able to give you the right diagnosis, assess your overall condition, and be able to provide assistance that will lead to a positive result.
The main thing, in this case, is to see a professional doctor. Unfortunately, many countries have adopted a radical fight against this disease. Therefore, the question, whether it is possible to cure without surgery, the answer is a resounding no. But in the USA, such treatment can be carried out much more gently. Clinics here offer to conduct surgery for breast cancer, but try to keep as much healthy tissue as possible. In addition, after surgery in such centers, you will certainly be offered plastic surgery to restore the breast.
So, if you or your loved one was diagnosed with breast cancer, even if it is stage 4, do not panic. Find a great oncologist, select the best treatment option, and start it immediately. With this approach, the probability of a positive outcome increases many times. Remember even the worst and most difficult diagnosis can be a thing of the past if you start the right treatment on time and believe in the best outcome.
Symptoms Of Metastatic Breast Cancer
The symptoms of stage 4 breast cancer depend on the location of the cancer and where it has spread in your body.
- If breast cancer has spread to your bones, you may notice a sudden new bone pain. Breast cancer most commonly spreads to your ribs, spine, pelvis, or arm and leg bones.
- If it has spread to your brain, you may experience headaches, vision or speech changes, or memory problems.
- Breast cancer that has spread to your lungs or liver usually causes no symptoms.
The main treatments for stage 4 breast cancer are targeted drug therapies that destroy cancer cells wherever they are in your body.
These treatments may include:
- hormone therapy, which stops or slows the growth of tumors by preventing your body from producing hormones or interfering with the effect of hormones on breast cancer cells
- chemotherapy, where drugs given orally or through an IV travel through your bloodstream to fight cancer cells
- immunotherapy, which uses drugs that stimulate your immune system to destroy cancer cells
- a combination of these therapies
The following are the common treatment options for different types of stage 4 breast cancer.
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Outlook For People With Stage 3 Breast Cancer
Its natural to want to know your outlook, but statistics dont tell the whole story. Your breast cancer type, overall health, and many more factors beyond your control may affect treatment outcomes.
Establishing open communication with your treatment team can help you best assess where you are in your cancer journey.
Support groups can be a great source of comfort as you navigate your diagnosis through your treatment and beyond. Your doctors office or hospital can offer some suggestions and resources in your area.
Box 1 How Rapid Autopsy Studies Can Inform On Metastatic Dissemination And Relapse
Rapid autopsy: rapid post-mortem collection, examination and biobanking of tissuesfresh, snap-frozen and fixedfrom deceased patients shortly after death.
Rapid autopsy cancer programme: coordinated effort among oncologists, pathologists and scientists aimed at collecting specimens from cancer patients within a post-mortem interval of 68h before key biological information within the tissues of interest is lost.
Multiregional biopsies: to conduct extensive, spatial sampling of tissuesprimary and metastatic, cancerous and normalfor in-depth, high-resolution multi-omics analysis.
Physiological model: to analyse DTCs in their natural metastatic niche.
to generate novel, ex vivo living patient-derived modelsautopsy-derived xenografts and organoids of metastatic tumours from sites that would otherwise be difficult to sample for functional evaluation .
Cancer evolution: to study the phylogenetic relationship of each sampled site to each other and infer the complete clonal evolution of a neoplasm.
Dormancy: to examine why some DTCs lodged in certain organs of the human body become dormant for years to decades.
Drug resistance: to study why DTC spread across different sites responds differently to therapy, with some developing resistance and others remaining sensitive to treatment.
Recurrence: to understand why only some DTCs residing in certain sites of the human body give rise to active metastases, ultimately responsible for patients relapse.
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What Questions Should I Ask My Healthcare Provider
You may want to ask your provider:
- What type of breast cancer recurrence do I have?
- Has the cancer spread outside the breast?
- What stage is the breast cancer?
- What is the best treatment for this type of breast cancer?
- What are the treatment risks and side effects?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Most breast cancer recurrences respond well to treatments. You may be able to try new drugs or combination therapies in development in clinical trials. Your healthcare provider can discuss the best treatment option based on your unique situation.
Last reviewed by a Cleveland Clinic medical professional on 03/24/2021.
What Are The Types Of Breast Cancer Recurrence
If you develop cancer in the opposite, untreated breast , you receive a new breast cancer diagnosis. This isnt the same as breast cancer recurrence.
When breast cancer returns, it may be:
- Local: Cancer returns in the same breast or chest area as the original tumor.
- Regional: Cancer comes back near the original tumor, in lymph nodes in the armpit or collarbone area.
- Distant: Breast cancer spreads away from the original tumor to the lungs, bones, brain or other parts of the body. This is metastatic cancer, often referred to as stage 4 breast cancer.
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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.
What Happens If Sentinel Node Is Positive
If the biopsy is positive, it means that cancer cells have been found in the sentinel lymph node. The surgeon may then proceed with axillary lymph node dissectiona more invasive procedure that involves removing more lymph nodes. For certain types of cancer, biopsy results are also used to determine the cancer stage.
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Can Chemo Cure Bone Cancer
Chemotherapy is a treatment for cancer. Chemotherapy can be used to treat bone cancer in four different ways: prior to surgery to reduce the size of the tumor and make surgery simpler. This method works especially well in the treatment of Ewing sarcoma when combined with radiotherapy before surgery .
How Quickly Do Breast Cancer Tumors Grow From Stage To Stage
Cancer cells divide and multiply quickly in such a way that as a tumor gets bigger, it divides and grows even faster. The average doubling time for breast cancer tumors is between 50 and 200 days. Breast cancer tumor growth rate is impacted by hormonal factors, such as hormone receptor status and HER2 status.
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Why Outcomes Are Improving
This study confirms what anecdotally weve known for a long timethat women with metastatic disease are living longer, with a better quality of life, says Harold Burstein, M.D., Ph.D., associate professor of medicine at Harvard Medical School and an oncologist at the Dana-Farber Cancer Institute in Boston. That’s especially true for younger women, and for women with the most aggressive and virulent cancers, who used to have few treatment options.
There are a few reasons:
More effective drugs. Medications such as trastuzumab significantly improve long-term survival of patients with HER2-positive breast cancer, one of the most virulent forms of the disease, especially when used in combination with other drugs. There are also new drugs on the market, such as palbociclib , approved by the FDA in 2015 to treat post-menopausal women with advanced breast cancer, which in clinical trials has doubled survival rates from 10 to 20 months.
Suddenly theres a whole subset of patients with a previously ominous prognosis who are now doing incredibly well long-term, staying in remission for five, seven, even 10 years, says Elisa Port, M.D., chief of breast surgery at Icahn School of Medicine at Mount Sinai and director of the Dubin Breast Center in New York City.