Metastatic Breast Cancer Treatment And Planning
After a diagnosis of metastatic breast cancer, its helpful to take all the time you need to gather information and make decisions about your treatment. Learn about the medical specialists that may be involved in your care, treatment options, genetic testing, taking a break from treatment, and more.
SurgeryDoctors sometimes recommend surgery for metastatic breast cancer in order, for example, to prevent broken bones or cancer cell blockages in the liver. Learn more.
ChemotherapyChemotherapy is used in the treatment of metastatic breast cancer to damage or destroy the cancer cells as much as possible. Learn more.
Radiation TherapyYour doctor may suggest radiation therapy if youre having symptoms for reasons such as easing pain and controlling the cancer in a specific area. Learn more.
Hormonal TherapyHormonal therapy medicines are used to help shrink or slow the growth of hormone-receptor-positive metastatic breast cancer. Learn more.
Targeted TherapyTargeted therapies target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow in a rapid or abnormal way. Learn more.
Local Treatments for Distant Areas of MetastasisLocal treatments are directed specifically to the new locations of the breast cancer such as the bones or liver. These treatments may be recommended if, for example, the metastatic breast cancer is causing pain. Learn more.
Enhancing Healthcare Team Outcomes
Treatment of metastatic lung lesions is a combined interprofessional team effort. It requires collaboration between oncologists and other specialists such as pathologists, pulmonologists, cardiothoracic surgeons, radiation oncologists, and interventional radiologists before a successful treatment plan can be outlined and carried out for the patient benefit. Oncology nurses and pharmacists are invaluable in providing ongoing care. Board-certified oncology pharmacists review medication for the dose and interactions and discuss various chemotherapy regimens with the oncologist. They provide education to patients and their families regarding how the drugs work and the adverse effects. Oncology nurses administer treatment, monitor patients for both effectiveness of therapy and adverse events, provide symptomatic care following chemotherapy, counsel the patients and their families, and inform the team of changes in patient status. This interprofessional collaboration will result in better patient outcomes for metastatic disease.
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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Whats The Outlook For Metastatic Breast Cancer
The right treatment plan can improve survival for people with metastatic breast cancer. However, survival rates vary and are dependent on a number of factors including type/biology of the breast cancer, parts of the body involved and individual characteristics. About 1 in 3 women live at least five years after diagnosis. Some live 10 years or longer. Your care team will discuss your prognosis with you in more detail.
What Is Metastatic Breast Cancer In The Lungs
Doctors refer to metastatic breast cancer as stage 4 breast cancer.
Metastatic is a term that refers to cancer that has spread outside of the original area to a different place in the body. Metastatic breast cancer in the lungs refers to cancer that originally developed inside the breast tissue but has spread to the lungs.
Breast cancer is the most common form of cancer among women. Around 610 percent of initial breast cancers that a doctor diagnoses are metastatic. This number does not include breast cancers that progress to stage 4 after the initial diagnosis. Typically, oncologists call metastatic breast cancer stage 4 breast cancer.
Some of these metastatic breast cancer cells may affect the lungs. It is essential that an oncologist confirms that the tumor in the lungs is secondary, meaning that it contains breast cancer cells. If there are no breast cancer cells present, the tumor could be a newly developed primary cancer.
People may not experience symptoms of metastatic breast cancer in the lungs immediately. If symptoms do appear, they can resemble those of a cold or flu.
Symptoms of metastatic breast cancer in the lungs include:
- a constant cough
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Treating Metastatic Breast Cancer
When treating metastatic breast cancer, the goal is to help minimize or eliminate symptoms and lengthen your life without sacrificing your quality of life.
Breast cancer treatment depends on many factors, such as the type of breast cancer, previous treatments, and your overall health. Another important factor is where the cancer has spread and whether the cancer has spread to multiple locations.
Treatment For Physical Symptoms
Several medications can help relieve pain. The American Cancer Society urge that a person should not have to endure pain in the final months and days of life.
Many people find relief with opioid medications, but these can cause side effects such as fatigue and constipation. A person may use opioids in combination with other pain relief medications, such as acetaminophen or ibuprofen.
Other drugs, such as antidepressants and antiseizure medications, can also treat certain types of pain.
Doctors can also prescribe medications for nausea and vomiting. Some drugs for treating nausea can make a person drowsy. However, these drugs may help people eat and drink more or simply make it easier for them to function and interact with other people.
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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.
How Do Doctors Diagnose Metastasis
If you already had cancer treatment for non-metastatic cancer, you probably have a follow-up care plan. You will see your doctor for regular checkups. Specific tests may be done to look for metastases.
Alternatively, some people already have metastases when they are first diagnosed with cancer. In this situation, the metastases are usually found during the initial tests to stage the cancer.
Cancer may cause symptoms such as pain or shortness of breath. Sometimes these symptoms will lead your doctor to do necessary tests to find the metastases.
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Where Does Metastatic Lung Cancer Spread To
Lung cancer can spread in several ways. Cancerous cells can grow into surrounding healthy tissues, including the lining of the lungs and nearby lobes. This is known as local metastasis. Or, cancerous cells can invade the lymph nodes and travel through the lymphatic system to other parts of the body. This is known as distant metastasis.
How Breast Cancer Spreads To The Lungs
Breast cancer starts in the breast. As the abnormal cells divide and multiply, they form a tumor. As the tumor grows, cancer cells can break away from the primary tumor and travel to distant organs or invade nearby tissue.
Cancer cells can enter the bloodstream or migrate to nearby lymph nodes under the arm or near the collarbone. Once in the blood or lymph systems, cancer cells can travel through your body and land in distant organs or tissue.
Once cancer cells reach the lungs, they can start to form one or more new tumors. Its possible for breast cancer to spread to multiple locations at the same time.
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What Complications Does Lung Metastasis Present
Every type of metastasis comes with its own risks for complications. Some of these complications may be serious, especially one with a compromised immune system due to treatment. Others are simply something to watch out for and try to avoid so that you can stay healthy enough to continue being treated and maintain a high quality of life.
One potential complication of lung metastasis is fluid in the chest. If cancer cells grow in the pleural space between the lung and the chest wall, they may cause a build-up of excess fluid, which leads to pain in the chest, coughing, shortness of breath, and wheezing. This is treatable by draining the fluid or performing a procedure called pleurodesis, in which the space between the lung and chest wall is manually closed so it cannot collect fluid.
Other potential complications of metastatic cancers include psychological impact and toxicity from treatment. You may experience depression, anxiety, or excess stress from the former, and it might be a good idea to seek psychological treatment to help you cope. With the latter, you could experience constipation, vomiting, nausea, loss of appetite, fatigue, infection, or just generally lowered immune system function. These are important symptoms to watch out for as you try to stay healthy.
Most importantly of all, do not lose hope! Metastatic breast cancer does not have to keep you from living a fulfilling life.
How Breast Cancer Spreads
Breast cancer can spread through the lymphatic system, the bloodstream, or by local invasionfor instance, when cancer cells actually invade nearby tissues, such as the chest wall or ribs.
When breast cancers spread and enter the lymphatic system, they usually first arrive at nearby lymph nodes and may still be early-stage.
Metastatic breast cancer is the same thing as stage 4 breast cancer and is considered the most advanced stage. It refers to breast cancers that have spread beyond the breast and nearby lymph nodes to other regions of the body, which are called distant metastases.
While treatment options for metastatic breast cancer are similar no matter where cancer has spread, some treatments are used for specific sites of metastasis as well .
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Metastatic Breast Cancer Symptoms And Diagnosis
The symptoms of metastatic breast cancer can vary greatly depending on the location of the cancer. This section covers the symptoms of breast cancer that has spread to the bone, lung, brain, and liver, and the tests used to diagnose metastatic breast cancer.
Bone Metastasis: Symptoms and DiagnosisThe most common symptom of breast cancer that has spread to the bone is a sudden, noticeable new pain. Breast cancer can spread to any bone, but most often spreads to the ribs, spine, pelvis, or the long bones in the arms and legs. Learn more.
Lung Metastasis: Symptoms and DiagnosisWhen breast cancer moves into the lung, it often doesnt cause symptoms. If a lung metastasis does cause symptoms, they may include pain or discomfort in the lung, shortness of breath, persistent cough, and others. Learn more.
Brain Metastasis: Symptoms and DiagnosisSymptoms of breast cancer that has spread to the brain can include headache, changes in speech or vision, memory problems, and others. Learn more.
Liver Metastasis: Symptoms and DiagnosisWhen breast cancer spreads to the liver, it often doesnt cause symptoms. If a liver metastasis does cause symptoms, they can include pain or discomfort in the mid-section, fatigue and weakness, weight loss or poor appetite, fever, and others. Learn more.
Common Sites Of Lung Cancer Metastases
Many people with lung cancer are all too aware that lung cancer can spread. Nearly 40% of those newly diagnosed with lung cancer are already at stage 4 and have metastases, cancer that has spread to other parts of the body. Symptoms and treatments for metastatic lung cancer vary depending on where the new tumors appear, but with each form, it’s important to review all of your options and to stay hopeful as you try to manage your condition.
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Can Metastatic Breast Cancer Go Into Remission
Metastatic breast cancer may never go away completely. But treatment can control its spread. Cancer may even go into remission at some points. This means you have fewer signs and symptoms of cancer.
A treatment break may be considered in certain situations, including if remission occurs or if someone is experiencing intolerable side effects. A pause in treatment can help you feel your best and improve your quality of life.
How Do Doctors Treat Metastasis
Treatment depends on:
The original cancer and where it started
How much the cancer has spread and where it is located
Your age and health
Your personal treatment choices
Researchers are learning more about how metastases may differ from the original tumor at the molecular and genetic level. This is why treatment for metastasis is often different from the treatment used for the original tumor.
Treatment may include chemotherapy or hormone therapy. Surgery and radiation therapy may also be options for some types of cancer. Doctors might try one type of treatment and then switch to another when the first treatment no longer works. Or you might have a combination of treatments.
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How Is Metastasis In The Lungs Diagnosed
If you have symptoms or are at high risk for lung metastasis, your doctor might start with a physical examination and blood tests and decide on the next step from there. Common tests to diagnose metastasis in the lungs include a chest X-ray, a CT scan, or a PET scan. Your doctor might also choose to test a mucus sample or perform a bronchoscopy or needle biopsy of the lung.
New Evidence Suggests Early Metastasis Is Common In Lung And Breast Cancers
It’s not news any cancer patient really wants to hear. Cancer geneticist Christina Curtis, PhD, and postdoctoral researcher Zheng Hu, PhD, have found that in breast and lung cancer patients with metastatic disease, the seeds of metastasis were often planted well before the primary tumor was diagnosed.
What’s more, treatments given to prevent recurrence after the primary tumor is removed — a category of therapy called adjuvant treatments that includes chemotherapy, hormone and targeted drug therapies — can end up promoting the growth of drug-resistant cells in the distant metastases.
Curtis and Hu published their results recently in Nature Genetics. The findings dovetail with their previous discovery that most colorectal cancers have metastasized before diagnosis. But although it may sound grim, the researchers emphasize that it’s important to understand how cancers evolve in the body in order to develop new treatments to better combat recurrence.
As Curtis explained:
Metastatic tumors have been under-characterized, in part because it has been difficult to get matched samples of primary and metastatic tumors from patients. Ours is the largest study to date, and addresses a long-standing question in the field as to how metastasis happens. Our findings indicate that, quite frequently in lung and breast cancers, metastasis occurs two to four years before the primary tumor has been detected.
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Lung Cancer With Skin And Breast Metastasis: A Case Report And Literature Review
Bikash Bhattarai et al.
1Department of Medicine, Interfaith Medical Center, 1545 Atlantic Avenue, Brooklyn, NY 11213, USA
Lung cancer is one of the most common cancers in America. Frequent sites of metastasis include the Hilar lymph nodes, adrenal glands, liver, brain, and bone. The following case report is of a primary lung cancer with metastases to the breast and skin. Case. A 48-year-old African American male with a past medical history of poorly differentiated left breast cancer status after modified radical mastectomy , chronic obstructive pulmonary disease, and smoking presents to the ER with progressive shortness of breath on exertion, upper back pain, and weight loss for 2 months in duration. On physical examination he is found to have a MRM scar on his left breast and a left periumbilical cutaneous mass. Chest X-ray and chest CT reveal a right upper lobe mass and biopsies from the breast, lung, and the periumbilical mass indicate a poorly differentiated carcinoma of unclear etiology all tumor markers are negative. The patient is male and a chronic smoker therefore the diagnosis is made as lung carcinoma with metastases to the breast and skin. . A high index of suspicion for cutaneous metastases should be cast when investigating cutaneous pathologies in patients at risk for primary lung malignancy.
2. Case History
Conflict of Interests
Newly Diagnosed Or Worried About A Symptom
In the days or weeks after a diagnosis of secondary breast cancer, you may feel distressed 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.
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A Man Patient With Ipsilateral Breast Metastasis From Pulmonary Adenocarcinoma
Pulmonary Medicine Department, Ataturk Chest Diseases and Thoracic Surgery Training and Researsh Hospital, Ankara, Turkey
Interventional Pulmonology Department, Ataturk Chest Diseases and Thoracic Surgery Training and Researsh Hospital, Ankara, Turkey
Interventional Pulmonology Department, Ataturk Chest Diseases and Thoracic Surgery Training and Researsh Hospital, Ankara, Turkey
Pathology Department, Ataturk Chest Diseases and Thoracic Surgery Training and Researsh Hospital, Ankara, Turkey
Treatment Of Lung Metastases
Surgery may be an option if there are a small number of lung metastases and there are no metastases in other parts of the body. Also, surgery would only be used if the main cancer is under control.
Controlling symptoms is important, especially if treatment for the main cancer is not effective or may take a while to help. Shortness of breath can be one of the hardest feelings to deal with. Morphine-like medicines can be used to help decrease the feeling of shortness of breath. Anti-anxiety medicines may be helpful if the morphine-like medicines dont work.
Having trouble breathing can make you feel anxious, worried, and even like you are in a panic. Some patients find the steps below helpful.
- A fan blowing cool air on you
Pain can also be hard to deal with, especially if you have other symptoms. Talk to your healthcare team about how you can use medicines and supportive methods to treat your pain.
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