What Is Metastatic Breast Cancer
When cancer that originates in the breast spreads, or metastasizes, to other parts of the body beyond the lymph nodes, it is known as metastatic breast cancer it is sometimes called Stage IV or advanced breast cancer.
Metastatic breast cancer can spread to just about any part of the body, but it most often spreads to the liver, lung, brain, or bones. Treatment of metastatic breast cancer aims to slow its progression, relieve symptoms, and help women live longer.
How A Breast Cancers Stage Is Determined
Your pathology report will include information that is used to calculate the stage of the breast cancer that is, whether it is limited to one area in the breast, or it has spread to healthy tissues inside the breast or to other parts of the body. Your doctor will begin to determine this during surgery to remove the cancer and look at one or more of the underarm lymph nodes, which is where breast cancer tends to travel first. He or she also may order additional blood tests or imaging tests if there is reason to believe the cancer might have spread beyond the breast.
What Are The Common Signs And Symptoms Of Breast Cancer
The following early signs and symptoms of breast cancer can happen with other conditions that are not cancer related.
- New lump in the breast or underarm
- Thickening or swelling of part of the breast
- Irritation or dimpling of breast skin
- Redness or flaky skin in the nipple area of the breast
- Pulling in of the nipple or pain in the nipple area
- Nipple discharge other than breast milk, including blood
- Any change in the size or the shape of the breast
- Pain in any area of the breast
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What Is Stage 0 Dcis
Stage 0 breast cancer, ductal carcinoma in situ is a non-invasive cancer where abnormal cells have been found in the lining of the breast milk duct. In Stage 0 breast cancer, the atypical cells have not spread outside of the ducts or lobules into the surrounding breast tissue. Ductal Carcinoma In Situ is very early cancer that is highly treatable, but if its left untreated or undetected, it can spread into the surrounding breast tissue.
M Categories For Breast Cancer
M followed by a 0 or 1 indicates whether the cancer has spread to distant organs — for example, the lungs, liver, or bones.
M0: No distant spread is found on x-rays or by physical exam.
cM0: Small numbers of cancer cells are found in blood or bone marrow , or tiny areas of cancer spread are found in lymph nodes away from the underarm, collarbone, or internal mammary areas.
M1: Cancer has spread to distant organs as seen on imaging tests or by physical exam, and/or a biopsy of one of these areas proves cancer has spread and is larger than 0.2mm.
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Breast Cancer Signs And Symptoms
Knowing how your breasts normally look and feel is an important part of your breast health. Although having regular screening tests for breast cancer is important, mammograms do not find every breast cancer. This means it’s also important for you to know what your breasts normally look and feel like, so youll be aware of any changes in your breasts.
The most common symptom of breast cancer is a new lump or mass . A painless, hard mass that has irregular edges is more likely to be cancer, but breast cancers can be also soft, round, tender, or even painful.
Other possible symptoms of breast cancer include:
- Swelling of all or part of a breast
- Breast or nipple pain
- Nipple or breast skin that is red, dry, flaking, or thickened
- Nipple discharge
- Swollen lymph nodes under the arm or near the collar bone
Many of these symptoms can also be caused by benign breast conditions. Still, its important to have any new breast mass, lump, or other change checked by an experienced health care professional so the cause can be found and treated, if needed.
Remember that knowing what to look for does not take the place of having regular screening for breast cancer.Screening mammography can often help find breast cancer early, before any symptoms appear. Finding breast cancer early gives you a better chance of successful treatment.
Where Do These Numbers Come From
The American Cancer Society relies on information from the Surveillance, Epidemiology, and End Results database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for breast cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead, it groups cancers into localized, regional, and distant stages:
- Localized: There is no sign that the cancer has spread outside of the breast.
- Regional: The cancer has spread outside the breast to nearby structures or lymph nodes.
- Distant: The cancer has spread to distant parts of the body such as the lungs, liver or bones.
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Early Signs Of Breast Cancer
Pinpointing breast cancer in its earliest stages isnt easy because breast cancer signs and symptoms are different for everyone. Sometimes there is a palpable lump or tenderness. Very often, there is neither. Generally, breast cancer shows no symptoms in the early stage.
However, there are certain changes in the breast that may indicate breast cancer in both men and women.
Whether you are a man or a woman, its important to become familiar with your breasts so you can recognize when changes occur and seek timely treatment. Know the facts and understand your risk factors for the disease, such as genetics and family history, by reviewing these frequently asked questions.
Early Warning Signs Of Breast Cancer
Common symptoms of breast cancer include:
- A lump in your breast or underarm that doesnât go away. This is often the first symptom of breast cancer. Your doctor can usually see a lump on a mammogram long before you can see or feel it.
- Swelling in your armpit or near your collarbone. This could mean breast cancer has spread to lymph nodes in that area. Swelling may start before you feel a lump, so let your doctor know if you notice it.
- Pain and tenderness, although lumps donât usually hurt. Some may cause a prickly feeling.
- A flat or indented area on your breast. This could happen because of a tumor that you canât see or feel.
- Breast changes such as a difference in the size, contour, texture, or temperature of your breast.
- Changes in your nipple, like one that:
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Breast Exam By Your Doctor
The same guidelines for self-exams provided above are true for breast exams done by your doctor or other healthcare professional. They wont hurt you, and your doctor may do a breast exam during your annual visit.
If youre having symptoms that concern you, its a good idea to have your doctor do a breast exam. During the exam, your doctor will check both of your breasts for abnormal spots or signs of breast cancer.
Your doctor may also check other parts of your body to see if the symptoms youre having could be related to another condition.
Stage 1b Breast Cancer Means One Of The Following Descriptions Applies:
Lymph nodes have cancer evidence with small clusters of cells between the approximate size of a pinprick to the approximate width of a grain of rice .
AND EITHER No actual tumor is found in the breast.
OR The tumor is smaller than the approximate size of a peanut .
Similar to stage 0, breast cancer at this stage is very treatable and survivable. When breast cancer is detected early, and is in the localized stage , the 5-year relative survival rate is 100%.
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What Are The Breast Cancer Stages
Staging helps describe how much cancer is in your body. Its determined by several factors, including the size and location of the tumor and whether the cancer has spread to other areas of your body. The basic breast cancer stages are:
- Stage 0. The disease is non-invasive. This means it hasnt broken out of your breast ducts.
- Stage I. The cancer cells have spread to the nearby breast tissue.
- Stage II. The tumor is either smaller than 2 centimeters across and has spread to underarm lymph nodes or larger than 5 centimeters across but hasnt spread to underarm lymph nodes. Tumors at this stage can measure anywhere between 2 to 5 centimeters across, and may or may not affect the nearby lymph nodes.
- Stage III. At this stage, the cancer has spread beyond the point of origin. It may have invaded nearby tissue and lymph nodes, but it hasnt spread to distant organs. Stage III is usually referred to as locally advanced breast cancer.
- Stage IV. The cancer has spread to areas away from your breast, such as your bones, liver, lungs or brain. Stage IV breast cancer is also called metastatic breast cancer.
What Is A 5
A relative survival rate compares women with the same type and stage of breast cancer to women in the overall population.For example, if the 5-year relative survival rate for a specific stage of breast cancer is 90%, it means that women who have that cancer are, on average, about 90% as likely as women who dont have that cancer to live for at least 5 years after being diagnosed.
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Lobular Carcinoma In Situ Symptoms
Lobular carcinoma in situ does not cause symptoms and cannot be seen with a mammogram. This condition is usually found when a doctor is doing a breast biopsy for another reason, such as to investigate an unrelated breast lump. If a person has LCIS, the breast cells will appear abnormal under a microscope.
Watch What You Eat And Drink
Healthy foods strengthen your body. Thereâs no special diet for people living with cancer, just the same foods we should all eat, like:
Fruits and veggies. Aim to eat 2 1/2 cups or more each day. Mix it up with dark green, red, and orange vegetables.
Whole grains. Look for bread, cereal, and brown rice that has 100% whole grain.
Fat. Stick with foods that have unsaturated fats like nuts, nut butter, avocado, and olive oil.
Things to eat and drink less of include red and processed meat, drinks sweetened with sugar, processed foods, and alcohol.
Remember also to get enough water. Itâs especially important if you have trouble keeping food down during cancer treatment. Or if youâve lost water from sweating, fever, or diarrhea. If you find water too bland, try:
Try swimming, playing tennis, or jogging to get your heart pumping even more. Experts suggest 150 minutes of exercise a week. That 30 minutes a day, 5 days a week. You can also include strength training two or more times a week. Be sure to ask your doctor whatâs safe.
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What Should A Person With Stage 0 Or Stage 1 Breast Cancer Expect Regarding Treatment
Even though Stage 0 breast cancer is considered non-invasive, it does require treatment, typically surgery or radiation, or a combination of the two. Chemotherapy is usually not part of the treatment regimen for earlier stages of cancer.
Stage 1 is highly treatable, however, it does require treatment, typically surgery and often radiation, or a combination of the two. Additionally, you may consider hormone therapy, depending on the type of cancer cells found and your additional risk factors. Like stage 0, Chemotherapy is often not necessary for earlier stages of cancer.
Material on this page courtesy of National Cancer Institute
Medically Reviewed on April 15, 2020
Find The Right Breast Cancer Specialist For You In Colorado
At Rocky Mountain Breast Specialists, we treat patients with breast cancer of all stages throughout Colorado. Our breast cancer specialists are up-to-date on the latest treatments for various types of cancer. We’re also actively participating in clinical research to help find new and better ways to care for breast cancer patients. Our dedicated team is available to help you if you need it.
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Brca1 Mrna Quantitative Real
Total RNA was isolated using the RecoverAllâ¢ kit , which includes DNAse treatment performed to remove genomic DNA. RNA was reverse transcribed to cDNA using SMARTScribeâ¢ reverse transcriptase and random nonamer primer. cDNAs were assayed in duplicate for expression of BRCA1 transcript levels as well as reference transcripts using specific primer and probe sets and TaqManÂ® chemistry . Cycle threshold values were calculated for each endpoint, corrected for housekeeping gene expression and relative gene expression was calculated using the ÎÎCt method. Expression is reported as multiples of the median.
What To Expect If You Are Diagnosed With Early
When found early, breast cancer patients have a very high likelihood of living a long and happy life as a cancer survivor. The American Cancer Society reports that localized breast cancer survivors have a 99% chance of 5-year survival. Regional cancer that is still early stage but has moved to local lymph nodes has an 86% chance of 5-year survival. Compare this to patients with distant breast cancer who have an average of a 28% 5-year survival rate, and you’ll quickly see why regular mammograms and self-monitoring can be lifesavers!
You will definitely have cancer treatments and a journey ahead of you, but it will most likely be shorter than if it was found at a later stage.
Treatment Of Breast Cancer By Stage
This information is based on AJCC Staging systems prior to 2018 which were primarily based on tumor size and lymph node status. Since the updated staging system for breast cancer now also includes estrogen receptor , progesterone receptor , and HER2 status, the stages may be higher or lower than previous staging systems. Whether or not treatment strategies will change with this new staging system are yet to be determined. You should discuss your stage and treatment options with your doctor.
The stage of your breast cancer is an important factor in making decisions about your treatment options. In general, the more the breast cancer has spread, the more treatment you will likely need. But other factors can also be important, such as:
- If the cancer cells have hormone receptors
- If the cancer cells have large amounts of the HER2 protein
- If the cancer cells have a certain gene mutation
- Your overall health and personal preferences
- If you have gone through menopause or not
- How fast the cancer is growing and if it is affecting major organs like the lungs or liver
Talk with your doctor about how these factors can affect your treatment options.
Stage 0 cancers are limited to the inside of the milk duct and are non-invasive .
Ductal carcinoma in situ is a stage 0 breast tumor.
What Does It Mean To Have Stage 1 Breast Cancer
In Stage 1 breast cancer, cancer is evident, but it is contained to only the area where the first abnormal cells began to develop. The breast cancer has been detected in the early stages and can be very effectively treated.
Stage 1 can be divided into Stage 1A and Stage 1B. The difference is determined by the size of the tumor and the lymph nodes with evidence of cancer.
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What Are The Types Of Breast Cancer
There are several different types of breast cancer, including:
Can cancer form in other parts of the breast?
When we say breast cancer, we usually mean cancers that form in milk ducts or lobules. Cancers can also form in other parts of your breast, but these types of cancer are less common. These can include:
- Angiosarcoma. This rare type of cancer begins in the cells that make up the lining of blood or lymph vessels.
- Phyllodes tumors. Starting in the connective tissue, phyllodes tumors are rare. Theyre usually benign , but they can be malignant in some cases.
What Is Stage 0 Lcis
Lobular carcinoma in situ at Stage 0 generally is not considered cancer. Although it has carcinoma in the name, it really describes a growth of abnormal but non-invasive cells forming in the lobules. Some experts prefer the name lobular neoplasia for this reason because it accurately refers to the abnormal cells without naming them as cancer. LCIS, however, may indicate a woman has an increased risk of developing breast cancer.
If you have been diagnosed with LCIS, your doctor may recommend regular clinical breast exams and mammograms. He or she may also prescribe Tamoxifen, a hormone therapy medication that helps prevent cancer cells from growing.
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Analysis Of Tcga Dataset For Brca1 Pm And Expression
We analyzed the TCGA breast cancer dataset for 56 TNBC specimens for which both expression and methylation data were available. Among the four probes included in the TCGA dataset, two probes flank and overlap with the region queried by the MSPCR we used to interrogate BRCA1 PM in our study. The two additional probes lay 105 and 307 base pairs downstream from the MSPCR locus, respectively . There was a significant inverse correlation between methylation and BRCA1 mRNA expression at all four probe sites individually, and when all were considered as a composite measure of methylation . There appeared to be a threshold at a composite Î²-value of approximately 0.2 , with expression of BRCA1 being significantly lower in the 21% of tumors with a methylation value beyond this threshold . Taken together, these data confirm that hypermethylation in this region is strongly associated with epigenetic silencing of the BRCA1 gene.
Correlation analysis between BRCA1 expression and methylation across 56 TNBC specimens obtained from the TCGA breast cancer database. Correlation coefficients and significance of methylation and mRNA expression from TCGA dataset. Association between BRCA1 promoter methylation and BRCA1 mRNA expression. Lines note median expression value, p value represents Mann-Whitney test.