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Is Bilateral Breast Cancer Metastatic

Many Women Live For Decades With Metastatic Breast Cancer

My Metastatic Breast Cancer Diagnosis Story

A stage 4 diagnosis is not an instant death sentence, says Renee Sendelbach, 40, from Austin, Texas, who was diagnosed seven years ago, when she learned that her breast cancer had moved into her lungs, bones, and lymph nodes.

Ive had metastatic breast cancer for five years and Im still kicking, says Susan Rosen, 53, from Franklin, Massachusetts.

According to a 2017 article in the journal;Cancer Epidemiology, Biomarkers & Prevention, 34 percent of women diagnosed with metastatic breast cancer have been living with the disease for five years or longer.

The goal of treatment is to keep patients on their feet as long as possible so that they can continue to do what they want to do, says;Gretchen Kimmick, MD, associate professor of medicine at the Duke Cancer Institute in Durham, North Carolina.

In recent years, treatment for breast cancer has vastly improved, largely because doctors are able to more accurately target therapy to the type of breast cancer a woman has. The discovery of the HER2 protein and medicines that block it has revolutionized treatment for women with cancers that overexpress this protein, Dr. Kimmick says. This cancer was pretty deadly two decades ago, and now we are starting to debate if weve cured it in some women.

What Are Risk Factors For Breast Cancer Recurrence

Anyone with a breast cancer diagnosis can have a recurrence. Your risk of cancer recurrence depends on several factors:

  • Age: Women who develop breast cancer before age 35 are more likely to get breast cancer again.
  • Cancer stage: Cancer stage at the time of diagnosis correlates with the risk of the cancer being able to recur. Several factors determine cancer stage: tumor size, cancer grade and cancer spread to lymph nodes or other parts of the body. Cancer grade indicates how unusual cancer cells look in comparison to healthy cells.
  • Cancer type: Aggressive cancers like inflammatory breast cancer and triple-negative breast cancer are harder to treat. Theyre more likely to come back and spread.

What Is Stage Ii Breast Cancer

Stage II describes cancer that is in a limited region of the breast but has grown larger. It reflects how many lymph nodes may contain cancer cells. This stage is divided into two subcategories.

Stage IIA is based on one of the following:

  • Either there is no tumor in the breast or there is a breast tumor up to 20 millimeters , plus cancer has spread to the lymph nodes under the arm.
  • A tumor of 20 to 50 millimeters is present in the breast, but cancer has not spread to the lymph nodes.

Stage IIB is based on one of these criteria:

  • A tumor of 20 to 50 millimeters is present in the breast, along with cancer that has spread to between one and three nearby lymph nodes.
  • A tumor in the breast is larger than 50 millimeters, but cancer has not spread to any lymph nodes.

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Compassionate Healing Starts Here

Breast Cancer Center

As the region’s only triple-accredited breast cancer center, our promise to you is world-class care delivered with deep compassion. Our experts are physicians and researchers who relentlessly pursue the best and latest treatments for your breast cancer, offering you hope for your diagnosis. To schedule an appointment, please call the UC Breast Cancer team at 513-584-5023.

Survival Rates For Breast Cancer

Bilateral Metastatic Lesions Secondary to 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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From Cured To Stage 4

Others, like Teri Pollastro, a 54-year-old stage 4 patient from Seattle, respond surprisingly well.

Diagnosed with early stage ductal carcinoma in situ in 1999, Pollastro underwent a mastectomy but did not receive chemotherapy, radiation or tamoxifen, since her cancer was ER negative.

âThey used the C-word with me, they told me I was cured,â she said. âEvery time I went back to my oncologist, he would roll his eyes at me when I had questions.â

In 2003, Pollastro switched to Seattle Cancer Care Alliance where she saw Dr. Julie Gralow, a breast cancer oncologist and clinical researcher at Fred Hutchinson Cancer Research Center. Gralow discovered Pollastroâs cancer had metastasized to her liver.

âMy husband and I were in shock,â said Pollastro of her mets diagnosis. âYou donât go from being cured to stage 4.â

Pollastro went on Herceptin, a type of immunotherapy for women with HER2-positive metastatic breast cancer, and did six months of chemotherapy.

âI felt better right away with the treatment,â she said. âBut the problem is, it stopped . Thatâs what you can expect with mets. And thereâs always some residual cancer. And that starts percolating.â

And along with mets, she also had to deal with many misconceptions regarding her disease.

The Mercer Island, Washington, mother of two, who often counsels newly diagnosed patients, sometimes even found it difficult to relate to early stage breast cancer survivors.

Selection Criteria And Quality Assessment

We have used the following inclusion criteria: Articles should be clinical trials, cohort study or case-control study with full text about the BBC with prognostic data in a specific population, region or country. The following information was extracted: study type, study location, sample size, age, mean follow-up duration, hazard ratio of overall survival with corresponding 95% confidence interval . HR of disease free survival was not compared due to insufficient data. We used the Newcastle-Ottawa quality assessment scale to assess the quality of identified studies. Only studies with NOS >5 which were regarded as high-quality were included. Disparity was resolved by consensus discussion between the two reviewers or by consultation with the third reviewer.

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When Can Metastatic Breast Cancer Occur

Most often, metastatic breast cancer arises months or years after a person has completed treatment for early or locally advanced breast cancer. This is sometimes called a distant recurrence.

Some people have metastatic breast cancer when they are first diagnosed . This is called de novo metastatic breast cancer.

Komen Perspectives

Gastric Metastasis Of Bilateral Breast Cancer

Bilateral ovarian metastases

Omar Jmour1, Asma Belaïd1, Fahmi Mghirbi2, Khalil Béhi2, Raoudha Doghri3, Farouk Benna1

1 Department of Medical Oncology, 3 Department of Pathology, Salah Azaiez Institute, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia

Correspondence to:

Keywords: Breast cancer; gastric metastasis; therapy

Submitted Jun 14, 2016. Accepted for publication Aug 24, 2016.

doi: 10.21037/jgo.2016.10.03

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Understanding Metastatic Breast Cancer

What is metastatic breast cancer?

When cancer starts in an organ and spreads to a different site, it is called metastatic. Cancers move from the original site using lymph channels or the bloodstream. Cancer spreads to the nearby region when tumor cells are identified in the lymph-node-draining areas of the breast. This regional breast cancer spread represents stage II or stage III breast cancer.

However, once the cancer cells travel beyond the regional lymph nodes, metastatic disease can be seen anywhere in the body. The most common locations for distant metastatic breast cancer are the bones, lungs, liver and brain. Spread to a distant body part is considered metastatic, or stage IV breast cancer.

When does metastatic breast cancer occur?

Sometimes cancers will have already spread to other parts of the body at the time of original diagnosis. However, this is rare, as approximately only 5% of patients will be considered metastatic or stage IV when they are first diagnosed. Usually, distant metastasis of the breast occurs after a woman has been diagnosed with an earlier staged cancer.

Metastatic breast cancer symptoms

Testing for metastatic breast cancer

Biopsies for metastatic breast cancer

Metastatic breast cancer treatment options and goals

Hormone therapy

Anti-estrogen therapy

Ovarian suppression

Ovarian ablation

Chemotherapy

Targeted therapies

Supportive treatment options

Radiation therapy

Bone-strengthening agents

UC Health Breast Cancer High Risk Program

Risk Factors Of Bilateral Breast Cancer

Risk Factors of Bilateral Breast Cancer

  • Women are more vulnerable to breast carcinoma.
  • If you have a history of atypical hyperplasia of the breast, you will likely suffer from this type of cancer.
  • A family history of breast cancer can be the primary reason for this disease in you.
  • If one of your breasts had been affected by cancer before, it could happen to both after a while.
  • Patients who received radiation therapy or have been exposed to radiation.
  • Your obesity can be one of the reasons causing breast carcinoma.
  • Beginning menopause at an older age can cause this cancer.
  • Having your first child at an older age or not having any child may cause this disease.
  • If you have gone through any hormone therapy, you are more likely to develop breast cancer.
  • Being addicted to alcohol can be a crucial factor that causes breast cancer.

However, there are some cases when the patient didnt have any risk factors but got affected by this disease. Maybe the main reason for having breast cancer being a woman biologically!

Well, there isnt a more logical explanation for this disease, I must say!

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More Information About The Tnm Staging System

The T category describes the original tumor:

  • TX means the tumor can’t be assessed.
  • T0 means there isn’t any evidence of the primary tumor.
  • Tis means the cancer is “in situ” .
  • T1, T2, T3, T4: These numbers are based on the size of the tumor and the extent to which it has grown into neighboring breast tissue. The higher the T number, the larger the tumor and/or the more it may have grown into the breast tissue.

The N category describes whether or not the cancer has reached nearby lymph nodes:

  • NX means the nearby lymph nodes can’t be assessed, for example, if they were previously removed.
  • N0 means nearby lymph nodes do not contain cancer.
  • N1, N2, N3: These numbers are based on the number of lymph nodes involved and how much cancer is found in them. The higher the N number, the greater the extent of the lymph node involvement.

The M category tells whether or not there is evidence that the cancer has traveled to other parts of the body:

  • MX means metastasis can’t be assessed.
  • M0 means there is no distant metastasis.
  • M1 means that distant metastasis is present.

Data Sources And Search Strategy

Bilateral Metastatic Lesions Secondary to Breast Cancer ...

The following databases had been searched for relevant studies: PubMed, Embase and Web of Science . The following medical subject headings and keywords were used for the search: Breast Neoplasm, Breast cancer, Bilateral. The language of literature was restricted to English. Reference lists of all the relevant articles were manually screened by two independent reviewers to ensure the sensitivity of literature search.

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Metastatic Breast Cancer Treatment And Planning

After a diagnosis of metastatic breast cancer, its helpful to take all the time you need to gather information and make decisions about your treatment. Learn about the medical specialists that may be involved in your care, treatment options, genetic testing, taking a break from treatment, and more.

SurgeryDoctors sometimes recommend surgery for metastatic breast cancer in order, for example, to prevent broken bones or cancer cell blockages in the liver. Learn more.

ChemotherapyChemotherapy is used in the treatment of metastatic breast cancer to damage or destroy the cancer cells as much as possible.;Learn more.

Radiation TherapyYour doctor may suggest radiation therapy if youre having symptoms for reasons such as easing pain and controlling the cancer in a specific area. Learn more.

Hormonal TherapyHormonal therapy medicines are used to help shrink or slow the growth of hormone-receptor-positive metastatic breast cancer.;Learn more.

Targeted TherapyTargeted therapies target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow in a rapid or abnormal way. Learn more.

Local Treatments for Distant Areas of MetastasisLocal treatments are directed specifically to the new locations of the breast cancer such as the bones or liver. These treatments may be recommended if, for example, the metastatic breast cancer is causing pain. Learn more.

Characteristics Of The Included Studies

The process and results of studies selection were shown in Figure . There were totally 954 articles identified, including 240 articles from the PubMed, 365 articles the Embase, and 349 articles from the Web of Science. 275 studies remained after exclusion of duplicates. We obtained 64 potentially relevant studies by sifting through the titles and abstracts. Another 49 studies were excluded for detailed reasons after full-text reviewing . Consequently, 15 studies were included and the characteristics of these studies were summarized in Table .

Figure 1

1.45

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Our Advice To Other Women With Metastatic Breast Cancer: Be Nice To Yourself

Give yourself a break! is the advice that Sendelbach offers. Stop negative self-talk about what you should have done but didnt do, she says. If you have MBC, you need to be kind and loving to yourself.

The body has only so much energy to offer per day, and managing metastatic breast cancer requires a lot of it. So it doesnt make sense to try to compare what youre able to do with what your cancer-free friends are accomplishing.

Just getting through the day can be hard, Sendelbach says. Getting rid of those not good enough feelings can lift a huge weight off you.

There Are Good Days And Bad Days

Dr. Julie Gralow on Treating Breast Cancer Bone Metastases

There are days when I say to myself, Ive had enough. I cant take it anymore, says Rosen. But I want to keep on living. I love my life. Overall, I have a great life except for the cancer.

Rosen has a few mantras she uses when things get tough. A lot of the tough times are treatment related, she says. I refer to those as bumps in the road, and , This too shall pass.

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Bilateral Breast Cancer Prognosis

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Metastatic Breast Cancer Symptoms And Diagnosis

The symptoms of metastatic breast cancer can vary greatly depending on the location of the cancer. This section covers the symptoms of breast cancer that has spread to the bone, lung, brain, and liver, and the tests used to diagnose metastatic breast cancer.

Bone Metastasis: Symptoms and DiagnosisThe most common symptom of breast cancer that has spread to the bone is a sudden, noticeable new pain. Breast cancer can spread to any bone, but most often spreads to the ribs, spine, pelvis, or the long bones in the arms and legs. Learn more.

Lung Metastasis: Symptoms and DiagnosisWhen breast cancer moves into the lung, it often doesnt cause symptoms. If a lung metastasis does cause symptoms, they may include pain or discomfort in the lung, shortness of breath, persistent cough, and others. Learn more.

Brain Metastasis: Symptoms and DiagnosisSymptoms of breast cancer that has spread to the brain can include headache, changes in speech or vision, memory problems, and others. Learn more.

Liver Metastasis: Symptoms and DiagnosisWhen breast cancer spreads to the liver, it often doesnt cause symptoms. If a liver metastasis does cause symptoms, they can include pain or discomfort in the mid-section, fatigue and weakness, weight loss or poor appetite, fever, and others. Learn more.

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What I Wish People Knew About Metastatic Breast Cancer

Women with metastatic breast cancer think about fighting cancer very differently than women who don’t have a stage 4 diagnosis. If you have advanced cancer, these women understand what youre going through.

The term metastatic breast cancer describes breast cancer that has spread beyond the breast to the bones, liver, brain, or another organ. Even if the cancer is found in another organ, its still referred to as breast cancer and is treated as such.

While metastatic breast cancer is terminal and cannot be cured, because of improved treatments more women are living longer than ever with it. Even so, a lack of information and many misconceptions about this diagnosis persist.

Here are several things you should know about metastatic breast cancer and the women who are living with it.

Histological Differences In Bilateral Breast Cancer

Metastatic breast cancer

The most common histopathological type was infiltrating ductal carcinoma . The rates of the same histopathological type were 93% in synchronous cancers but only 59% in metachronous cancers . The concordance rates of histological grade were 50% in synchronous cancers and 33% in metachronous cancers . The rate that tumors belonged to the high intraductal component group was 20% in two tumors of synchronous cancer and 16% in second tumors of metachronous cancer .

Figure 1.

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How Do I Prevent Bilateral Breast Cancer

Well, this disease may happen to anyone, even to people who are not exposed to the risk factors. But if you have it in your genetic history or want to take precautions against it, you can try the prevention tips I am stating below.

  • Consult a doctor for breast screening and ask them to perform mammograms or other clinical breast exams to determine if anything is wrong.
  • Discuss with your doctor about various breast screening process to figure out the most suitable one for yourself.
  • Learn everything about self-exam so you can perform breast screening by yourself at home. If you find anything out of the book, consult your doctor immediately.
  • Restrain your alcohol intake or put an end to it if possible.
  • Maintain a healthy lifestyle by exercising, eating healthy foods, and live a green life.
  • If you feel the necessity of going through hormonal therapy after therapy, discuss the advantage or disadvantages of it with your doctor.
  • Maintain a proper weight as obesity can lead you to breast cancer.
  • Eat healthy foods and superfoods that can help you to prevent harmful health conditions.

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