Outlook Once Cancer Has Spread To The Bones
The research on cancer metastasis is rapidly growing. As researchers better understand the mechanisms of bone metastasis, new drugs and other treatments are being developed. These target particular processes in cells involved in how the cancer cells invade and grow in bones.
The use of nanoparticles to deliver drugs is very encouraging. These tiny particles are able to deliver drugs to the bone with minimal toxicity to the person with cancer.
Rapidly treating bone metastasis can lead to a
What Is A Primary Tumor
The primary tumor refers to the original breast tumor. So, any metastases are either secondary tumors, or simply metastatic breast cancer.
Note, when breast cancer spreads to the bones, it is not bone cancer, it is metastatic breast cancer in the bones.
Metastatic describes a breast cancer that has already spread to distant areas and organs of the body. Metastatic cancer is the most advanced stage of breast cancer. Furthermore, the most common sites for breast cancer to metastasize to are the:-
- bones
- liver
- lungs.
Once breast cancer is at this most advanced metastatic stage, the odds of completely curing the breast cancer are quite low. .
The treatment of metastatic breast cancer, after a reasonable effort, will often focus on the quality of life and relieving symptoms rather than a cure.
Survival Rates For Inflammatory Breast Cancer
Inflammatory breast cancer is considered an aggressive cancer because it grows quickly, is more likely to have spread at the time its found, and is more likely to come back after treatment than other types of breast cancer. The outlook is generally not as good as it is for other types of breast cancer.
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.
Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.
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What Is Metastatic Cancer
Metastatic cancer is a cancer that has spread from the part of the body where it started to other parts of the body. When cancer cells break away from a tumor, they can travel to other parts of the body through the bloodstream or the lymph system.
This image shows some parts of the lymph system, like lymph nodes and lymph vessels, as well as organs and tissues that contain many lymphocytes .
If the cells travel through the lymph system, they could end up in nearby lymph nodes or they could spread to other organs. More often, cancer cells that break off from the main tumor travel through the bloodstream. Once in the blood, they can go to any part of the body. Many of these cells die, but some may settle in a new area and start to grow.
Cancer cells must go through several steps to spread to new parts of the body:
- They must find ways to break away from the original tumor and enter the bloodstream or lymph system.
- They need to attach to the wall of a blood or lymph vessel and move into a new body part.
- They need to find ways to grow and thrive in their new location.
- They must be able to avoid attacks from the bodys immune system.
Sometimes the metastatic tumors have already begun to grow when the cancer is first found. And sometimes, a metastasis may be found before the original tumor is found. If a cancer has already spread to other parts of the body before its first diagnosed, it may be hard to figure out where it started.
Treatment For Secondary Breast Cancer
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team .
Your doctor and nurse will talk to you about the best treatment for you. They will also ask you about your preferences. They will talk to you about things to consider when making treatment decisions. You may have some treatments as part of a clinical trial.
Secondary breast cancer can be controlled, often for many years, but it cannot be cured. Because of new and improved treatments, women with secondary breast cancer are living for longer. The aim of treatment is to control the cancer, improve the symptoms and help you to live well for longer.
The treatment you have will depend on:
- where the cancer is in your body
- if it is ER positive or HER2 positive
- previous breast cancer treatment you have had.
You may have a combination of treatments.
Treatments for secondary breast cancer include:
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Oncogene Expression May Negatively Impact Breast Cancer Results
A comparatively new addition to the discussion of prognosis and breast cancer survival data is oncogene expression. An oncogene is a small fragment of genetic material which can causeâ ordinary cells to eventually become malignant, and which can be carried on a chromosome. The oncogene HER-2 in particular is linked to aggressive breast cancers. On average, women with HER-2 amplification get a substantially greater danger of dying within a couple of years from breast cancer, in comparison to girls without HER-2 amplification.
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Can Metastatic Breast Cancer Be Cured
There is no cure for metastatic breast cancer. Once the cancer cells have spread to another distant area of the body, its impossible to get rid of them all. However, the right treatment plan can help extend your life and improve its quality.
Metastatic breast cancer treatment aims to shrink tumors, slow their growth and improve your symptoms.
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Progression While Being Treated With Hormone Therapy
For hormone receptor-positive cancers that were being treated with hormone therapy, switching to another type of hormone therapy sometimes helps. For example, if either letrozole or anastrozole were given, using exemestane, possibly with everolimus , may be an option. Another option might be using fulvestrant or an aromatase inhibitor , along with a CDK inhibitor. If the cancer has a PIK3CA mutation and has grown while on an aromatase inhibitor, fulvestrant with alpelisib might be considered. If the cancer is no longer responding to any hormone drugs, chemotherapy is usually the next step.
How Quickly Breast Cancer Develops
You may have heard remarks that cancer has been present for five years before it is diagnosed, and this may sometimes be true.
The actual time it takes for breast cancer to grow from a single cancer cell to a cancerous tumor is unknown, as estimates based on doubling time assume that this is constant throughout the duration of tumor growth.
If doubling time were constant, cancer with a doubling time of 200 days would take 20 years to develop into a detectable tumor, and a doubling time of 100 days would take 10 years to be evident on exam.
In contrast, a breast tumor with a doubling time of 20 days would take only 2 years to develop.
Since the majority of studies have found the average doubling time to be between 50 days and 200 days, it’s likely that most breast cancers that are diagnosed began at least 5 years earlier .
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What Is Metastatic Breast Cancer
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.
Factors That Affect Growth Rate
A number of different studies have demonstrated some of the factors that influence the rate of growth of a breast cancer. These include:
- The type of cancer: Inflammatory breast cancer tends to grow much more rapidly than other types of breast cancer
- Age at diagnosis: Breast cancers in young women tend to grow more rapidly than breast cancers in older women and have a higher tumor grade
- Menopausal state: Breast tumors often grow more rapidly for women who are premenopausal than for those who are postmenopausal, likely due to estrogen in the body.
- Receptor status: Triple negative cancers, in general, grow more rapidly than estrogen receptor-positive tumors. Triple positive tumors also grow more rapidly.
- Estrogen treatment: Women who used hormone replacement therapy after menopause had, in general, more rapid growth rate of breast tumors.
- Ki-67 index: A higher index means a faster doubling time.
- Tumor grade: A higher tumor grade indicates a faster doubling time.
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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:
How Long After Breast Cancer Treatment Do Recurrences Occur
The risk of recurrence for all breast cancers was highest in the first five years from the initial cancer diagnosis at 10.4%. This was highest between the first and second years after the initial diagnosis. During the first five years after the initial diagnosis, patients with oestrogen receptor positive breast cancer had lower rates of recurrence compared with those with ER negative disease. However, beyond five years, patients with ER positive disease had higher rates of recurrence.
The late recurrence or relapse of breast cancer refers to cancers that come back after five years, but may not return for 10 years, 20 years, or even more. For people who have estrogen receptor-positive tumours, the cancer is actually more likely to recur after five years than in the first five years.
In contrast to the common belief that surviving for five years after cancer treatment is equivalent to a cure, with hormone-sensitive breast tumours there is a steady rate of recurrence risk for at least 20 years after the original diagnosis, even with very small node-negative tumours.
An awareness of the risk of late recurrence is important for a number of reasons. People are often shocked to learn that their breast cancer has come back after say, 15 years, and loved ones who dont understand this risk are often less likely to be supportive as you cope with the fear of recurrence.
Bone Metastases
- Spine
- Pelvis
- The long bones of the arms and legs
Symptoms and Detection
Treatment
Liver Metastases
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Additional Tools For Diagnosing Advanced Breast Cancer
The additional tools below are often used specifically for diagnosing advanced cancer:
Sentinel lymph node biopsy: This procedure removes sentinel lymph node cells during surgery for examination. When breast cancer spreads, it often heads first to the lymph nodes.
Chest X-ray: This detailed image of the chest may help doctors see whether cancer has spread to the bones.
Computed tomography scan: Also known as a CAT scan, this procedure takes detailed pictures of internal areas of the body using a computer linked to an X-ray machine. A dye may be used to help the organs show up more clearly in the images.
Bone scan: This procedure looks for bone metastasis, or cancer cells that have spread to the bone. A small amount of radioactive material is injected into the blood, then detected with a scanner.
Positron emission tomography scan: A PET scan is a detailed imaging tool that uses a radioactive drug, known as a tracer, to search for cancer cells within your body.
How Does Breast Cancer Spread
Breast cancer spreads when abnormal cells invade surrounding healthy tissues. In most cases, breast cancer first spreads to other parts of an affected breast, then to nearby lymph nodes. If cancerous cells make their way into the lymphatic system, they can then reach distant parts of the body.
The most common locations for metastatic breast tumors include the:
- Lungs
- Bones
- Brain
Even if breast cancer spreads to a distant organ, it is still classified as breast cancer. For instance, breast cancer that spreads to the lungs is considered to be metastatic breast cancer not lung cancer.
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Can You Do Anything To Prevent Or Slow The Spread Of Breast Cancer
Like any type of cancer, there are factors that can put you at higher risk. For breast cancer, these include things like smoking, unhealthy diet, lack of exercise and not performing monthly self-breast exams. Its also important to make sure and get your annual mammogram for breast cancer screening.
Other risk factors can include using hormone-based prescriptions, how many children youve had in the past, getting older and at what age you got your period and went through menopause.
In some instances, you cant necessarily prevent breast cancer, but you can sometimes slow it down, stop it from spreading or reduce the size of the tumor, says Dr. Roesch. You can do this by taking your medications as directed, following through with treatments, going to your appointments and being involved in your cancer care.
Youre in control of taking your medication correctly, eating a healthy diet, participating in an exercise program and managing stress. All of these things can contribute to a stronger physical body and better mental attitude both of which can have a positive impact on your breast cancer diagnosis.
Symptoms Of Secondary Breast Cancer
The symptoms of secondary breast cancer depend on where in the body the cancer has spread to. If it has spread to the bones there might be a painful area in a bone. If it has spread to a lung it may cause breathlessness.
Some people have general symptoms. They may feel generally unwell for no obvious reason. Tell your doctor or nurse if you have any new symptoms. If you are worried, we have more information about the symptoms of secondary breast cancer.
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A Different Treatment Schedule
Treatments for advanced breast cancer may go on without an end date to keep the disease under control. You’ll visit the clinic on a regular basis, and you’ll get to know your health care team.
“If the treatment works, you’ll stay on it as long as it’s working well without side effects,” says Rita Nanda, MD, of the University of Chicago’s breast cancer program. If it’s not working well or has bad side effects, your doctor will try different treatments.
Your doctor is likely to suggest chemotherapy, because it travels through your entire body. “Metastatic breast cancer is a whole-body disease,” Mayer says.
You will also need hormone therapy if your cancer is sensitive to the hormone estrogen or progesterone. Some people can take targeted treatments, which are drugs that work directly on the changes within cancer cells. These combinations can make chemotherapy work better.
Sometimes surgery or radiation can help ease symptoms.
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.
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Plans Have To Be Flexible
My energy is unpredictable, says Sendelbach. I literally never know how Im going to feel from one day to the next. Its so hard to make plans because if I say yes to something thats two weeks away, the day of, I could wake up and feel absolutely horrible.
When someone with metastatic breast cancer declines an invitation or cancels at the last minute, its most likely not because they dont want to be there. Says Sendelbach, We physically cant do it.
Silberman agrees. Ive been going through for a long time, she says, and Ive had friends drop away. Because of MBC and my treatments, its hard for me to be reliable.