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How Is Metastatic Breast Cancer Diagnosed

Support When You Have Secondary Breast Cancer

Newly diagnosed with metastatic breast cancer

Secondary breast cancer occurs when breast cancer cells spread from the first cancer in the breast through the lymphatic or blood system to other parts of the body. Read more about diagnosis, treatments and living with secondary breast cancer, and find support.

Secondary breast cancer is not the same as breast cancer recurrence. If you are concerned about your primary breast cancer returning, find information and support.

Does Metastatic Cancer Mean I Have A New Type Of Cancer

Breast cancer that forms in a secondary site is still breast cancer. For example, if breast cancer cells settle in the lungs, you now have metastasized breast cancer in the lungs or lung metastases not lung cancer. Your doctor will run tests to determine the cause of the secondary cancer. This distinction matters because treatment for lung metastases is different than treatment for lung cancer.

What Do The Categories Her2

HER2 is a protein that acts as a receptor on the surface of the cancer cell. It also acts as a fertilizer, causing the cancer cells to reproduce. All breast cancer cells have some HER2 receptors, but about 20-30% of patients have breast cancers with many extra copies of this protein. If you have extra HER2, your cancer can be classified as HER2 positive.

You may be treated with trastuzumab , a targeted therapy that can block the HER2 receptor. Usually, trastuzumab is administered along with chemotherapy. Or you may be treated with newer targeted therapies, such as lapatinib , which inactivates both the HER2 receptor and the related HER1 receptor, or with other agents that may become available in the future.

Some cancers are classified as all three at the same time: ER+, PR+ and HER2+.

Your cancer could also be classified as Triple Negative, meaning that it would not be responsive to the above targeted therapies but would be most effectively treated with chemotherapeutic agents. Chemotherapy, a systemic therapy that interupts cell growth and division, can be given orally or intravenously. In addition, clinical trials are analyzing the benefits of new agents to fight triple negative disease.

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How Does Metastatic Breast Cancer Develop

In some women with breast cancer, cancer cells break away from the cancer in the breast. The cancer cells spread to other parts of the body in blood vessels or lymphatic vessels and form a new cancer deposit. This can happen before or after treatment for breast cancer.The original cancer in the breast is called the primary cancer. If breast cancer develops in another part of the body it is called a metastatic breast cancer or a metastasis.

Treatment For Advanced Breast Cancer

Metastatic Sites and Symptoms of ILC

Treatment of metastatic breast cancer aims to control the growth and spread of the cancer, to relieve symptoms, reduce pain, and improve or maintain quality of life.

The treatment recommended by doctors will depend on which treatments are likely to control the breast cancer and what side effects the person can cope with. Treatment options may involve:

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Survival Rates Of Stage 4 Breast Cancer

Unfortunately, cancer cells often become more difficult to treat and may develop drug resistance once they spread. According to the Australian Institute of Health and Welfare , the 5-year survival rate for women whose breast cancer is metastatic at first diagnosis is 32%, compared to the 91% on average for all breast cancer patients.

Factors affecting survival rate of metastatic breast cancer

Survival rates can provide an estimate of what percentage of patients with the same stage of breast cancer are still alive after a certain period of time . However, they cannot predict how long any specific individual with breast cancer will live. The length of survival time for people with metastatic breast cancer can vary significantly from person to person, but there are a number of factors which can influence this including:

  • Response to treatment
  • The extent and location of metastases
  • The presence of other health issues not related to cancer
  • The specific subtype of breast cancer . This is very important, as some types of cancer can be more aggressive than others and respond differently to treatment.

Diagnosis Of Metastatic Breast Cancer

Dear River3,

I am so sorry to hear your news and an especially sorry that it took so long for the doctors to come to the right diagnosis. I presume you are in the care of a breast consultant and nurse now- how are they? What treatment plan have they suggested and when is the trial starting? Can they give you something for your pain?

Not dissimilar to your case, my father had a type of blood disease that his doctors could have detected had they did a more thorough check and read his bloods in full. As a result, the disease was undetected for 1 year and a half before he was diagnosed and he passed away six months later. My heart smashed into a million pieces and remains broken ever since.

He’s a real positive thinker and was trying whatever treatment he was being given, which I see you are doing that too. Treatments nowadays are so advanced and I know personally so many cases where ppl have survived years beyond what the doctor told them to expect. In the case of my Dad, he was living with my mother who screamed at him all day most days and blamed him for ‘getting sick and putting her in a difficult situation’ and he’s didnt get to rest much and still had to conversely do the groceries, housework and take care of my mother who was otherwise healthy. So, he was psychologically and emotionally spent.

Please stay strong as its a true wonder what the mind can help the body with. Sending you lots of light and love.

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What Are The Symptoms Of Metastatic Breast Cancer

The symptoms of metastatic breast cancer vary depending on where the cancer has spread in the body. Evelyn Toyin Taiwo, MD, hematologist and oncologist at Weill Cornell Medicine and NewYork-Presbyterian Brooklyn Methodist Hospital, tells Health these symptoms, based on which part of the body is affected, include:

  • Bone: New, unexplained pain in bones and joints commonly seen in the hip or lower back
  • Liver: Abdominal pain or discomfort

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Will I Need More Than One Treatment For Metastatic Breast Cancer

Metastatic breast cancer: A guide for the newly diagnosed

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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Has My Tumor Been Sent For Testing

We often send the tumor for a genomic profile analysis, Dr. Fasano says. This analysis tells us if there are any mutations in the tumor, which could help us decide what future therapies we can use to treat the cancer. Also, if a tumor has a particular mutation, it may make someone eligible for a clinical trial.

How Metastatic Breast Cancer Is Diagnosed

Diagnosing metastatic breast cancer can involve different tests and lab procedures, depending on where the cancer metastasizes. For example, the location of the cancer may spread to the lungs, bone, brain, or liver. The tests used to diagnose metastatic breast cancer may differ for each area or organ that is involved.

Metastasis involves the spread of cancer to distant areas or organs of the body. When it spreads to two or more distant areas, this is known as metastatic cancer or stage IV disease. Breast cancer that spreads to local areas such as the lymph nodes is not considered metastasis, but rather, locally advanced breast cancer.

In the majority of cases, metastatic cancer is diagnosed after a cancer has already been treated at an earlier stage. But in 6% to 10% of all cases of breast cancer, the cancer has already spread at initial diagnosis and is considered stage IV. Therefore, its easy to understand why early diagnosis of breast cancer is so vital.

Breast cancer can spread to different parts of the body, most commonly to the bones, the brain, lungs, liver or even to the skin. Sometimes, other organs are involved. It’s important to note that breast cancer that spreads to any of these sites is not the same as cancers that originate in them.

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Questions To Ask Your Doctor If Youre Diagnosed With Metastatic Breast Cancer

Getting any breast cancer diagnosis can feel impossible to navigate. And a stage IV breast cancer diagnosis can feel infinitely more overwhelming. Stage IV breast canceralso known as metastatic breast cancer is a cancer that originated in the breast but has spread elsewhere in the body. Its considered a terminal diagnosis.

I think the most important first step is to take a deep breath and remember that, although metastatic breast cancer is not curable, it is treatable, says , M.D., a medical breast oncologist at Mount Sinai Health System in New York City. Women can do so well for such a long time without experiencing significant side effects related to their underlying cancer and from the treatment itself.

But how do you get from diagnosis to doing well? Step one: Come to your medical oncology consultation with a loved one, Dr. Fasano says. Having another person present to act a second set of ears is so important.

Besides a loved one, Dr. Fasano shares seven questions you should bring with you as well.

What Side Effects Can I Expect

Metastatic adenocarcinoma definition, symptoms, diagnosis ...

As youre considering potential courses of treatment, you should understand the possible side effects of each. There is so much that the doctors and nurses can do to mitigate the side effects of any treatments, Dr. Fasano says. We want to do everything we can to help patients maintain a good quality of life while undergoing cancer treatment.

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What Are My Treatment Options

Treatment options include chemotherapy, targeted therapies, and sometimes radiation and surgery.

If your cancer cells are found to be hormone responsive, the hormones estrogen and progesterone that exist naturally in our bodies can actually fuel your cancer. This is commonly referrd to as ER positive or PR positive status.

If your tumor is ER+ and/or PR+, you may not only benefit from traditional chemotherapy, but also from targeted, hormonal therapies. These therapies may include drugs such as tamoxifen, which blocks estrogen after it is produced from binding to the estrogen receptor, aromatase inhibitors, which interfere with the production of estrogen fulvestrant , which destroys the estrogen receptor , or other agents that may be developed in the future.

If you are pre-menopausal, you may benefit from a reduction in estrogen production through ovarian suppression using monthly injections. Surgical removal of the ovaries may also be recommended.

Diagnosis Of Liver Metastasis

When breast cancer metastasizes to the liver, there are usually no initial symptoms. Therefore, a liver function test may be a standard blood test ordered by the healthcare provider during a follow-up exam for those who have been diagnosed with breast cancer. The liver function test involves removing blood from a vein, and then sending the blood sample to the lab to test for certain levels of enzymes and protein in the blood. Abnormal levels indicate liver damage or liver disease.

Other tests commonly used to diagnose liver metastasis include imaging tests such as:

  • MRI
  • Ultrasound, and/or PET scan .
  • A combined PET/CT scan

In addition, the diagnosing healthcare provider may order a sample of the tissue in the suspicious area this is called a liver biopsy. A liver biopsy is obtained using imaging tools to guide the physician in inserting a small needle through the skin to collect the liver tissue sample.

Another method of obtaining the liver tissue for biopsy is called a laparoscopy. This involves using a specialized scope to operate, through a very small incision in the abdomen to remove the suspicious tissue. The tissue samples are then examined in the lab to determine if they contain breast cancer tissue. If the tissue is cancerous, it can further be tested to determine its hormone receptor and HER2 status, which can guide the use of targeted therapies.

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Relieving Symptoms Of Advanced Breast Cancer

Treatment to relieve symptoms depends on where the cancer has spread. For example, pain from bone metastases may be treated with radiation therapy, drugs called bisphosphonates such as pamidronate or zoledronic acid , or the drug denosumab . For more, see our information about the treatment of bone metastases.

What Is Metastatic Breast Cancer

My Metastatic Breast Cancer Diagnosis Story

Metastatic breast cancer is the most advanced stage of breast cancer. Breast cancer develops when abnormal cells in the breast start to divide uncontrollably. A tumor is a mass or collection of these abnormal cells.

Metastasis refers to cancer cells that have spread to a new area of the body. In metastatic breast cancer, cells may spread to the:

  • Bones.
  • Liver.
  • Lungs.

Healthcare providers name cancer based on its primary origin. That means breast cancer that spreads to other body parts is still considered breast cancer. The cancer cells are still breast cancer cells. Your care team will use breast cancer therapies, even if the cancer cells are in other areas.

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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

Surgery and/or radiation therapy may be useful in certain situations .

Treatment can often shrink tumors , improve symptoms, and help women live longer. These cancers are considered incurable.

Metastatic Breast Cancer Scans

Diagnostic scans are performed to find out if you have MBC and to measure response to treatment or progression of metastatic tumors. No matter how many times you have been through a scan, there is often anxiety involved in either the process itself or waiting for results. This is normal.

The most typical scans are:

Bone Scans

Bone scans reveal if cancer has spread to the bones. In most MBC cases, metastases first occur in the bones. These scans look at the bones for hot spots that may reveal cancer. To conduct a bone scan, your healthcare provider injects dye, then waits a few hours for it to move through the bloodstream so it can be visible in the scan.

Chest X-Ray

A chest x-ray may reveal if breast cancer has spread to the lungs. Metastases in the lungs rarely cause pain, but they can cause shortness of breath or a cough that wont go away.

CT/CAT Scan

This scan provides a more-detailed x-ray of the body, usually in order to look for metastases in the brain, lungs and/or liver. Before the scan, you will either ingest a contrast dye and/or have it injected into a vein. The dye highlights specific areas of the body more clearly. A computer rotates around the body, creating a three-dimensional image.

Liver Scan

A liver scan involves having a contrast dye injected into the vein. The dye will collect in areas where there is activity that could indicate cancer growth.

PET Scan

PET CT Scan

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What Is Secondary Breast Cancer

Secondary breast cancer is when cancer cells from a cancer that started in the breast spread to other parts of the body. The cancer that started in the breast is called primary breast cancer.Secondary breast cancer is also called advanced breast cancer or metastatic breast cancer. The most common places for breast cancer to spread to are the:

Rarely, breast cancer may spread to other parts of the body, such as the bone marrow, ovaries or lining of the tummy which is called the peritoneum.Breast cancer can spread to different parts of the body. This does not mean it will go to all these places.

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Why Does The Treatment For Metastatic Disease Seem Less Aggressive Than Treatment For Early

Cancerâs Spread to Bone

Treatment of early-stage disease focuses on curing the breast cancer and therefore tends to be immediate and aggressive. In contrast, because there is no cure for metastatic breast cancer at this time, treatment focuses on controlling the disease and permits a more measured, long-term approach to therapy. This allows for more conservative treatment that reduces the incidence of adverse side effects.

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How Will I Be Monitored

Imaging tests, ranging from CT scans and MRIs to bone scans and PET scans, may be used to monitor changes in the size and location of the breast cancer metastases and to assess your response to therapy. Sometimes, blood tests measuring tumor markers, such as CA15-3, CA 27-29 and carcinoembryonic antigen , can provide clues to the clinical behavior of breast cancer.

While tumor markers can be indicative of tumor behavior, most oncologists do not recommend changing treatment based on tumor markers alone.

Diagnosis Of Secondary Breast Cancer

You may be diagnosed with secondary breast cancer after having tests to check a new symptom. This could be through your GP or at a breast cancer follow-up clinic. Sometimes there may be no obvious symptoms and the diagnosis is made after routine follow-up tests.

Some women who have just been diagnosed with primary breast cancer have tests that show the cancer has already spread to other parts of the body. Sometimes the secondary breast cancer is diagnosed first and tests show that it first started in the breast.

Your cancer doctor or nurse will ask you about your symptoms and general health. You may need some of the following tests:

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