Is Stage 4 Breast Cancer Curable
Theres currently no cure for stage 4 breast cancer, but with treatments it can be kept under control, often for years at a time.
People with metastatic breast cancer need to receive treatments for the rest of their lives. If a certain treatment stops being effective, another treatment regimen may be tried.
What Is The Treatment For Inflammatory Breast Cancer
Breast cancer treatment for inflammatory breast cancer typically involves chemotherapy, surgery, and radiation. In some cases, additional targeted therapies are given. The term neoadjuvant refers to therapies that are given before surgery, while adjuvant refers to treatments given after surgery.
- Neoadjuvant chemotherapy refers to chemotherapy medications that are given before surgery to shrink the tumor. In patients with inflammatory breast cancer, this is often done so that the tumor is smaller and easier to remove during the surgery. A typical course of neoadjuvant chemotherapy would involve at least six cycles of chemotherapy over four to six months. The chemotherapy regiment usually involves taxane and anthracycline drugs.
- If the tumor cells express the HER2 protein , targeted therapies such as trastuzumab can also be given as a neoadjuvant therapy and continued after surgery .
- Inflammatory breast cancers are often positive for the HER2 protein, so the tumors can be responsive to treatments that target this protein. In addition to trastuzumab, other drugs that target HER2 activity are available.
Challenges Of Diagnosing Ibc
Routine mammography may miss IBC because of its rapid onset, which may happen between scheduled mammograms.
IBC can also be hard to see on a mammogram. IBC often spreads throughout the breast or it may only show up as a sign of inflammation, such as skin thickening .
In some cases, skin changes or a lump may be noted during a clinical breast exam.
IBC may first be mistaken for an infection or mastitis because of symptoms such as redness and swelling, and the frequent lack of a breast lump.
If you have any of the warning signs listed above and they last longer than a week, tell your health care provider. Its always OK to get a second opinion if youre not comfortable with your health care providers recommendation.
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Living With Stage : The Breast Cancer No One Understands
Editor’s note: We’re bringing back this piece from October 2014 for Metastatic Breast Cancer Awareness Day and to honor Jody Schoger, featured in the story. Schoger died of metastatic breast cancer in May. Want to learn more about MBC? Look for our tweets at the Northwest Metastatic Breast Cancer Conference this Saturday at Fred Hutch.
A no-nonsense Texan of 60 years, Jody Schoger* has a very no-nonsense way of educating people about her metastatic breast cancer.
âSomeone will say, âWhen are you done with treatment?â and Iâll tell them, âWhen Iâm dead,ââ said Schoger, a writer and cancer advocate who lives near Houston. âSo many people interpret survivorship as going across the board. That everybody survives cancer now. But everybody does not survive cancer.â
An estimated 155,000-plus women in the U.S. currently live with âmets,â or metastatic breast cancer. This type of cancer, also called stage 4 breast cancer, means the cancer has metastasized, or traveled, through the bloodstream to create tumors in the liver, lungs, brain, bones and/or other parts of the body. 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.
Stomach Upset Loss Of Appetite And Weight Loss
It can be more difficult to eat a healthy diet as these symptoms occur, setting up a vicious cycle. As women avoid certain foods because of stomach upset, the digestive system may lack the fiber and nutrients it needs to function optimally.
Over time, women may lose their appetite and have difficulty taking in the calories they need. Not eating regularly may cause significant weight loss and nutritional imbalances.
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Mammographic And Ultrasound Features Of Inflammatory Breast Cancer
The typical findings on screening for inflammatory breast cancers are thickening of the skin and connective tissues and an increase in breast density.
In around 30% of inflammatory breast cancers cases there is no lump . Rather IBC usually presents as a diffuse infiltration of cancer cells, so it is not as easily detected on mammogram or ultrasound.
So, the absence of a true breast mass on mammography does not always rule out cancer.
In addition, the high density of the breast might hide an actual tumor deeper within the breast.
Ultrasound can be helpful in the diagnostic process, as it may be able to detect masses hidden at mammography and on clinical examination.
Ultrasound is also useful to detect axillary adenopathy and this can help with taking more accurate biopsy samples. With inflammatory breast cancer, ultrasound images might show edema and skin thickening along with an ill-defined mass of some kind.
Coping With Stage 4 Breast Cancer
It is natural to feel depressed, anxious, or even angry when you have been diagnosed with stage 4 breast cancer. It can leave you feeling as if you have no control over your health or future. Moreover, you may find that certain people will withdraw from you or suggest that you have metastatic cancer because you “left it too long.”
It is important to shield yourself from these negative emotions and embrace people who can provide you with genuine support. These include loved ones, support groups, and your oncology team. If you are unable to cope, ask for a referral to a therapist who can provide you counseling or a psychiatrist able to dispense treatment.
With that being said, there are women who experience positive emotional growth after being diagnosed with stage 4 breast cancer. It is not uncommon to hear someone say that cancer helped prioritize their life, allowing them to pursue what is truly important and connect with people on a deeper, more profound level.
Whatever your experience, don’t go it alone. Seek support and work with your medical team as a full partner in your care.
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What Are The Stages Of Ibc And What Do They Mean
IBC doesnt usually appear like typical breast cancer, and it may be hard to catch early. Because of this, by the time IBC is diagnosed, its progressed to a more advanced stage. IBC is a type of cancer that grows into the skin, which means its already at stage 3 when it develops. So, while it forms in the milk ducts, there’s no way to know a person has the disease until outward signs appear. Usually, you’ll see changes in your skin because the lymph vessels are blocked. Like other types of breast cancer, IBC tends to spread to nearby lymph nodes first.
Part of the diagnostic process involves your care team determining the specific stage of breast cancer. These include:
- Stage 3B, which means cancer has spread to nearby areas of the breast, such as the ribs and muscles in the chest or the skin
- Stage 3C, which means the tumor is larger or has spread to nearby tissues
- Stage 4, which means the cancer has spread to other areas of the body
Its important for an accurate and timely diagnosis and staging so treatment can be started without delay.
Treating Inflammatory Breast Cancer
Inflammatory breast cancer that has not spread outside the breast is stage III. In most cases, treatment is chemotherapy first to try to shrink the tumor, followed by surgery to remove the cancer. Radiation and often other treatments, like more chemotherapy or targeted drug therapy, are given after surgery. Because IBC is so aggressive, breast conserving surgery and sentinel lymph node biopsy are typically not part of the treatment.
IBC that has spread to other parts of the body may be treated with chemotherapy, hormone therapy, and/or targeted drugs.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
American Joint Committee on Cancer. Breast. In: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer 2017:589.
Curigliano G. Inflammatory breast cancer and chest wall disease: The oncologist perspective. Eur J Surg Oncol. 2018 Aug 44:1142-1147.
Hennessy BT, Gonzalez-Angulo AM, Hortobagyi GN, et al. Disease-free and overall survival after pathologic complete disease remission of cytologically proven inflammatory breast carcinoma axillary lymph node metastases after primary systemic chemotherapy. Cancer. 2006 106:10001006.
National Cancer Institute. Inflammatory Breast Cancer. 2016. Accessed at https://www.cancer.gov/types/breast/ibc-fact-sheet on August 30, 2021.
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Data Paints A More Complete Picture
The U-M study analyzed data from the National Cancer Institutes known as Surveillance, Epidemiology, and End Results, or SEER. The analysis was unique in including not only patients who had a diagnosis of IBC based on pathology reports, but also those with clinical symptoms consistent with IBC bringing the number of patients included in the study to nearly 30,000.
The team included two epidemiologists from the U-M School of Public Health: Yaoxuan Xia and Bhramar Mukherjee, Ph.D., chair of the department of biostatistics and a member of the Rogel Cancer Center.
We found that in these additional patients, the incidence rates by race were consistent with previously reported trends. This gave us confidence that our method was uncovering additional cases that had gone underreported in the past or were possibly misclassified in previous analyses, says study senior author Sofia Merajver, M.D., Ph.D., director of the Breast and Ovarian Cancer Risk and Evaluation Program at the Rogel Cancer Center. So therefore we believe our study is able to offer the most comprehensive assessment of incidence and survival rates of IBC to date.
Inflammatory Breast Cancer And Hormone Receptor Status
Inflammatory breast cancer tumors often have increasedangiogenesis and lymphangiogenesis.
Furthermore, IBC tumors also frequently show an overexpression of HER-2, RhoC GTPase, and NF–B genes.
Inflammatory breast cancers are more likely to be negative for Estrogen receptor status and/or progesterone receptor status .
Inflammatory breast cancer tumors have a higher frequency of ER- and PR- tumors in comparison to other advanced breast cancer tumors. Indeed, some studies show that up to 83% of IBC tumors are ER-. This tends to affect the efficacy of treatment as the tumors do not respond to hormone therapy.
Data from the Surveillance, Epidemiology and End Results database show a higher median survival rate in inflammatory breast cancer ER+ tumors compared with ER- tumors .
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What Does It Mean To Have Stage 4 Breast Cancer
Stage 4 breast cancer means that the cancer has spread to other areas of the body, such as the brain, bones, lung and liver.
Although Stage 4 breast cancer is not curable, it is usually treatable and current advances in research and medical technology mean that more and more women are living longer by managing the disease as a chronic illness with a focus on quality of life as a primary goal. With excellent care and support, as well as personal motivation, Stage 4 breast cancer may respond to a number of treatment options that can extend your life for several years.
Inflammatory Breast Cancer Prognosis
The prognosis, or likely outcome, for a patient diagnosed with cancer is often viewed as the chance that the cancer will be treated successfully and that the patient will recover completely. Inflammatory Breast Cancer treatment outcome would depend on all of the following factors like:
Also, Women with Stage III have better chances of coming out of IBC easily than women in Stage IV. Women with grade I or grade II tumors have better prognosis. Chances are less with grade III tumors. Women with estrogen receptor positive have better prognosis.
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Women With Inflammatory Breast Cancer Are Living Longer But The Gap Between White And Black Patients Persists
A U-M Rogel Cancer Center study provides an updated, more comprehensive look at trends for this rare, aggressive form of breast cancer over the last four decades.
Women with inflammatory breast cancer a rare, highly aggressive form of the disease are living about twice as long after diagnosis than their counterparts in the mid-to-late 1970s, according to a new University of Michigan Rogel Cancer Center study.
The researchers found that from 1973-1977, patients diagnosed with inflammatory breast cancer, also known as IBC, survived for an average of about 50 months, compared to 100 months for patients diagnosed from 2008-2012.
But despite overall improvements in survival, the analysis showed an ongoing disparity between white patients and Black patients. And while the gap has narrowed slightly over time, white patients today still tend to live about two years longer than their Black peers, the group found.
The incidence of IBC among Black women is also more than 70% higher than in white women, affecting 4.5 Black women out of 100,000 compared to 2.6 white women, according to the study, which was published in Breast Cancer Research and Treatment.
A Disease No One Gets
Sadly, people donât âgetâ mets. In fact, a recent survey sponsored by Pfizer Oncology shows just how misunderstood it is. Sixty percent of the 2,000 people surveyed knew little to nothing about MBC while 72 percent believed advanced breast cancer was curable as long as it was diagnosed early. Even more disheartening, a full 50 percent thought breast cancer progressed because patients either didnât take the right treatment or the right preventive measures.
âTheyâve built an industry built on four words â early detection equals cure â and that doesnât even begin to define breast cancer,â said Schoger, who helped found Breast Cancer Social Media, a virtual community for breast cancer patients, caregivers, surgeons, oncologists and others. âWomen are blamed for the fate of bad biology.â
The MBC Alliance, a consortium of 29 cancer organizations including the biggest names in breast cancer , addressed this lack of understanding and support as well as what many patient advocates term the underfunding of MBC research in a recently published landmark report.
Prediction Of Inflammatory Breast Cancer Survival Outcomes Using Computed Tomography
- 1Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea
- 2Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea
- 3Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
- 4Institute of Nuclear Medicine, University College London Hospitals NHS Trust, London, United Kingdom
- 5Medical Science Research Center, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea
Background: Although inflammatory breast cancer has poor overall survival , there is little information about using imaging features for predicting the prognosis. Computed tomography -based texture analysis, a non-invasive technique to quantify tumor heterogeneity, could be a potentially useful imaging biomarker. The aim of the article was to investigate the usefulness of chest CT-based texture analysis to predict OS in IBC patients.
Lower mean attenuation, MPP, and entropy on chest CT images predicted worse OS in patients with IBC, suggesting that CT-based texture analysis provides additional predictors for OS.
Jerris Story: Living With Stage 4 Inflammatory Breast Cancer
In 2001, Jerri Johnson was diagnosed with stage 4 inflammatory breast cancer. She has lived with metastatic breast cancer for more than 20 years. This is her story in her own words.
I was 35 when I was diagnosed with stage 4 inflammatory breast cancer . Newly married, my future was bright and all of a sudden, this breast cancer diagnosis came. And it obviously changed plans, a lot of plans, along the way. But there are good parts, and outcomes of that as well, and wonderful support from family and friends. Health care providers that really were willing to try interesting, cutting-edge things to help save my life.
One of those cutting-edge things was trying a chemotherapy cocktail that had just come out of initial clinical trials. My oncologist said, Hey, were going to try this. It stopped the progression of my cancer. We were able to go in and address the different metastases, and were able to get into a position where my cancer could be managed.It has been manageable for the last 20 years.
So, after that experience, I asked my oncologist: What was the turning point? And she said it really was this research out of MD Anderson that was funded by Komen.And I didnt know anything about Susan G. Komen. Were not really a cancer family.I didnt know what an oncologist was until my surgeon told me that I needed an oncologist. It was really from ground zero that we learned about this space.
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Risk Of Recurrence And Metastatic Breast Cancer
Due to the involvement of the skin in IBC, the risk for local recurrence probability of lymph node metastasis is very high.
For this reason, breast physicians rarely suggest an immediate mastectomy and instead will prescribe a course of preoperative chemotherapy.
Also, your physician will usually perform a full staging workup. A work-up involves chest x-ray scans, bone scans, and even abdominal ultrasound scans.
After chemotherapy, some patients may then undergo a full or modified radical mastectomy, along with axillary lymph node dissection.
After surgery, treatment with radiation therapy to the regional lymph nodes and to the chest wall usually follows.
Finally, women will likely receive endocrine therapy or other targeted therapies specific to the hormone receptor status.
The active stage of treatment for inflammatory cancer of the breast is intensive and difficult and usually takes about 1 year to complete.