Does Metastatic Breast Cancer Go Into Remission

Bone Metastases And Bone Problems

People with bone metastases are at risk of serious bone complications such as bone fractures , spinal cord compression and bone pain.

Bone complications are a concern for people with bone metastases as they can cause pain and may lead to loss of mobility, impacting quality of life. Bone complications can also decrease survival . With the use of bone-strengthening drugs, bone complications are not common .

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:

• Jaundice
• 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
• Chest pain
• 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.

The Return Of A Disease Thought Defeated

Crowes cancer was finally defeated after a year of chemo. She followed up with her doctor and her scans continued to read clean for four years, drawing close to the milestone five-year mark. For many cancer survivors, reaching five years without recurrence means a higher chance of improved survival rates.

So it was devastating news when Crowes health took a drastic turn, and her breast cancer returned.

This time, her doctor recommended a double mastectomy and an aromatase inhibitor. An aromatase inhibitor is a medication that helps block estrogen, a hormone that stimulates cancer growth. The treatments worked. Crowes cancer is now in remission again.

But being in remission isnt the same as being cured, and the possibility of recurrence significantly alters how a person experiences their day-to-day life. While Crowe doesnt experience the usual symptoms of breast cancer anymore, feelings of uncertainty still loom over her perspective in many ways.

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What Is The Life Expectancy For Stage 4 Breast Cancer

Stage 4 breast cancer life expectancy can vary depending on several factors. The following factors can affect your life expectancy with metastatic breast cancer:

• Age
• Amount of hormone receptors and HER2 receptors on cancerous cells
• Tissues that the cancer has affected

There is still not a clear answer for how long can you live with stage 4 breast cancer because it can vary greatly from patient to patient. Other factors such as past and current treatments being used also can have an effect on the life expectancy for patients.

Survival For All Stages Of Breast Cancer

Generally for women with breast cancer in England:

• Around 95 out of every 100 women survive their cancer for 1 year or more after diagnosis
• Around 85 out of every 100 women will survive their cancer for 5 years or more after diagnosis
• Around 75 out of every 100 women will survive their cancer for 10 years or more after diagnosis

Cancer survival by stage at diagnosis for England, 2019Office for National Statistics

These statistics are for net survival. Net survival estimates the number of people who survive their cancer rather than calculating the number of people diagnosed with cancer who are still alive. In other words, it is the survival of cancer patients after taking into account that some people would have died from other causes if they had not had cancer.

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Newly Diagnosed Or Worried About A Symptom

In the days or weeks after a diagnosis of secondary breast cancer, you may feel in turmoil 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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What Is Secondary Breast Cancer In The Bone

When cancer that started in the breast has spread to the bones, its called secondary or metastatic breast cancer in the bone.

Some people also refer to it as bone metastases or bone mets.

The bones most commonly affected are the:

• Spine
• Pelvis
• Upper bones of the arms and legs

The cells that have spread to the bone are breast cancer cells. Its not the same as having cancer that starts in the bone.

Breast cancer cells can spread to the bone through the lymphatic system or the blood.

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Stage 4 Cancer Symptoms

The symptoms of metastatic cancer depend on the type of cancer. In some cases, there are no symptoms at all.

Most of the time, a cancer that reaches stage 4 will affect not only the part of the body where it originated, but the areas it has spread to as well.

Stage 4 cancer also can cause more general symptoms, such as extreme fatigue and lack of energy. Some people become so tired and weak they have trouble doing everyday things. They may even need help with getting dressed or other routine tasks.

Hearing your doctor call a liver tumor “breast cancer” may sound strange. But stage 4 cancer is diagnosed based on where the original cancer is located, not where it has spread. So, breast cancer that has spread to the liver will be called stage 4 breast cancer with liver metastasisnot stage 4 liver cancer.

Is There More Than One Type Of Remission

Cancer remissions are often classified as either partial or complete. A partial remission or partial response signifies a reduction of at least 30% of a measurable tumor within the body. By contrast, a complete remission or complete response indicates all detectable evidence of cancer is gone.

Not every patient will be told theyre in remission. Some may be informed their disease is stable, meaning it hasnt progressed, or that it has shrank, or grown, by only a small amount. A few millimeters on a scan is typically considered not to be clinically significant.

If a patient is told they have disease progression, that means the cancer has grown, either in one area or multiple areas.

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Pink Ribbons Arent A Sign Of Positivity

Its often referred to as the good cancer, and the pink ribbon campaign communicates that women diagnosed with the disease should feel positive, Crowe mentions, believing our culture paints breast cancer in a positive light. The month of October has even been called Pink October. But pink is a color most people associate with peppy things, like bubblegum, cotton candy, and lemonade.

Crowe says she and many other women living with breast cancer are concerned the pink ribbon campaign may suggest we should celebrate finding a cure for breast cancer. One potential downside of this positivity is that it can ignore many womens fears about recurrence and death. The ribbon campaign may also cause women with late stage or metastatic cancer to feel left out, since they wont ever recover from their illnesses.

What Is Stage 4 Breast Cancer

What is stage 4 breast cancer? Also referred to as stage iv breast cancer, is considered stage 4 once it has spread beyond the breast tissue and nearby lymph nodes to other organs or parts of the body. In most cases, breast cancer will spread to the bones, lungs, or liver. Not as often, but in some cases, breast cancer can also spread to other organs such as the brain.

A stage 4 breast cancer diagnosis is confirmed by examining factors of the American Joint Committee on Cancer TNM system, which includes:

• Size of the tumor

Take the breast cancer quiz to learn more about stage 4 breast cancer.

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Will It Come Back

It can. This is called recurrence. But if youâre in remission, your breast cancer probably wonât come back. Most people with breast cancer never have a recurrence. But itâs possible. Sometimes, cancer cells linger even after treatment and then multiply later. It may happen months or years after you finish treatment.

There are different types of recurrence:

Local recurrence is when the cancer returns to your breast, chest wall, or lymph nodes. If you had a lumpectomy, it may show up in the breast tissue thatâs still there. If you had a mastectomy, it can affect the tissue in your skin or chest wall. If it returns to nearby lymph nodes, doctors will call it a regional recurrence.

Local recurrence usually happens within the first 5 years after youâve been diagnosed.

Distant recurrence is when breast cancer spreads to other organs. It goes beyond your breasts and nearby lymph nodes. It may spread to your bones, liver, lungs, brain, or other organs.

You may hear the doctor call this metastasis.

There are effective treatments for breast cancer that comes back.

During regular follow-up visits, your doctor will check for symptoms or signs that your cancer is back. Talk to them about your personal risk of recurrence and what you can do about it.

What Does Cancer Remission Mean

Cancer remission is when the signs and symptoms of cancer have lessened or are undetectable.

In blood-related cancers like leukemia, this means youll have a decrease in the number of cancer cells. For solid tumors, that means that the tumor size has decreased. The decrease must last for at least one month to be considered remission.

types of cancer remission

There different types of remission:

• Partial. A reduction of at least 50 percent in measurable tumor size or cancer cells
• Complete. All detectable evidence of cancer is gone.
• Spontaneous. When cancer goes into remission without therapy considered adequate to otherwise lead to remission. This usually happens after a fever or infection, and is rare.

Remission is not a cure, and it doesnt mean that youre totally cancer-free. Even in complete remission, there can still be some cancer cells in your body, and these can start growing again.

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Chance Of Remission And Recurrence

When cancer goes into remission, tests that look for cancer cannot detect it. A doctor may refer to this pathological complete response.

Treatment may also cause partial remission. This means that treatment has destroyed a portion of the cancer but that tests can still find the cancer.

Stage 4 breast cancer will not go away completely. However, notes that treatment can help control the cancer for years. It notes that the cancer can be active at times and go into remission at other times.

Because stage 4 breast cancer is not curable, it will not disappear and then recur.

Survivor Isnt The Right Term

Even though the word survivor is frequently used to describe women who have overcome breast cancer, Crowe doesnt identify with this label.

Survivor suggests that something horrible like an automobile accident or the loss of a loved one happened, and you were lucky enough to get past it, but cancer is not a one-time event, she says.

Crowe explains that for many people, cancer returns. For this reason, being on the other side of chemo feels more like disease management than survival.

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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

What Does It Mean To Be In Remission For Cancer Dana

• Metastatic prostate cancer usually responds to hormonal therapy and goes into remission, but cancer cells can sometimes resist treatments. Prostate cancer cells can learn how to grow, even without male hormones. Doctors call this condition hormone-resistant prostate cancer
• The goal is to enhance the patients immune system with many more T-cells that recognize and attack metastasized tumor cells. This study reports on a single patient whose metastatic breast cancer is still in remission after more than 22 months following ACT. Relevance
• Currently available combination chemotherapy treatment for stage IV cancer results in complete remission in up to 20% of patients, with average survival of 8-12 months. As newer drugs, such as the taxanes, Camptosar ® , and Gemzar ® , are incorporated into regimens, this may continue to improve
• Between 20 and 30 percent of women with early stage breast cancer go on to develop metastatic disease. While treatable, metastatic breast cancer cannot be cured. The five-year survival rate for stage 4 breast cancer is 22 percent median survival is three years. Annually, the disease takes 40,000 lives

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How Often It Happens

Though we have clearly documented cases of spontaneous regression, its hard to know how common this phenomenon actually is. We know it is not rare, with over a thousand case studies in the literature. In addition to those studies which document a cancer which goes away without any treatment, its not clear how often a cancer make go away despite treatment or at least decrease in size despite treatment.

Some have estimated the incidence to be roughly one out of 100,000 people, but its difficult to know if that number is even in the ballpark. It does appear to be more common with some tumors rather than others, with spontaneous regression of blood-related cancers such as lymphoma, and skin cancers such as melanoma being reported more commonly.

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

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How To Lower Your Risk Of Recurrence

There are things you can do to make it less likely that your breast cancer comes back. Some treatments and lifestyle choices have been shown to lower the risk.

Here are treatments that may lower your risk of recurrence:

• Bone-building drugs may cut your risk of cancer coming back in your bones.
• Chemotherapy. Research suggests people who have chemotherapy have a lower risk of recurrence.
• Hormone therapy. If you have receptor-positive breast cancer, hormone therapy after your first treatment may lower your risk of it coming back.
• Radiation therapy. Research suggests people who have radiation to treat inflammatory breast cancer or a large tumor have a lower risk of it returning.
• Targeted therapy. Drug treatments that target the protein HER2 may lower your risk if your cancer makes extra HER2 protein.

Lifestyle choices that help prevent a recurrence include:

• Eating healthy food like vegetables, fruits, and whole grains. Try to limit alcohol to no more than one drink a day.
• Getting regular exercise. Be active.
• Staying at a healthy weight

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How Have Targeted Therapies Changed The Treatment Of Metastatic Breast Cancer

With all the effective, modern therapies that we have today, its possible for patients to live for a long time with metastatic cancer many of them with no evidence of disease. For many patients, metastatic breast cancer becomes more like a chronic condition and can be kept under control, especially while patients are on active therapy and as long as their tumors dont become resistant to the drugs.

One type of therapy that has made a big difference in keeping metastatic breast cancer at bay is a class of drugs that target HER2, a protein that is overexpressed, or amplified, in about 20% of breast cancers. Therapies that block this protein can substantially shrink tumors and have very few side effects.

Most breast cancers are driven by hormones, such as estrogen and progesterone. Hormone therapies drugs that target the estrogen receptor or block estrogen production for patients with hormone receptorpositive breast cancer are effective. There are many different hormone therapies available, so if a patient has been taking one for a long time and it stops working, we can try a second, or even a third, drug.

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