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.
What Are The Signs Of Breast Cancer
While breast is more common in older women, it does affect;the younger generation and men too with around 20 per cent of cases occurring in females under 50 and;350 male cases diagnosed in the UK annually.
While 90 per cent of such lumps are not cancerous, it is vital to get them checked by your GP at the earliest opportunity detecting the disease early can mean treatment is more effective.
It is therefore vitally important to be “breast aware” – know what feels normal for you, and therefore what changes to look out for.
The most common signs to know include:
- A;lump or swelling;in the breast, upper chest or armpit. You might feel the lump, but not see it.
- Changes in the size or shape;of the breast
- A;change in skin texture;i.e. puckering or dimpling of the skin
- A;change in the colour;of the breast – the breast may look red or inflamed
- Rash, crusting or changes;to the nipple
- Any;unusual discharge;from either nipple
How Breast Cancer Treatment Has Changed Over The Years
Doherty, who says the project is the first acting thing Ive done about cancer, didnt use her health to help her co-stars.
I didnt have to give anybody advice because and these beautiful ladies who did such a beautiful job with their own preparation process, she said.
In the movie, Hus character creates a bucket list. Thats not something Doherty intends to do.
I just think a bucket list is odd in my particular situation because it means that Im sort of trying to check things off before my time runs out, she said.
Im very much like theres no bucket list because Im going to be the longest-living person with cancer. If I had to say one, it would just be living. Thats the only thing on my list at this point.
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What Is Advanced Stage Iv Breast Cancer
Stage IV is the most invasive of all stages of breast cancer. At this stage, the cancer has spread beyond the breast and nearby lymph nodes to other organs of the body such as the lungs, distant lymph nodes, skin, bones, liver or brain.
“Stage IV is often called advanced or metastatic breast cancer, it’s definitely scary for most patients. It’s widespread but varies per person,” Cruz said. “But I’ve had patients come up to me crying, thinking they’re going to die tomorrow but they live dozens of more years.”
Cance and Cruz said stage IV can appear after a different stage of breast cancer was treated. In most stage IV cases, doctors take an aggressive form of treatment involving surgery, chemotherapy and more.
How can you treat breast cancer?
Treatment for breast cancer can vary depending on the stage, Cruz said, though most treatments involve some form of radiation or hormone therapy to shrink the cancer cells.
Cruz said some women opt to take a “drastic” preventative measure via a mastectomy. A mastectomy is surgery to remove the breast tissue, often where cancer cells are found or could later be found.
“At first, the cancer will be biopsied and depending on the tumor characteristics, the treatment plan will involve surgery and possible chemotherapy or hormonal therapy and radiation,” Cance said.
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Why Does My Provider Need To Test The Metastatic Tumor
Your care team will test the metastases to figure out the biology of the tumor, which can help guide your treatment plan. Providers may test tumors for:
- Hormone receptor status: If the cancer is hormone receptor-positive, hormonal therapy may be your first treatment.
- HER2 status: Human epidermal growth factor receptor 2 is a protein that is overexpressed on some breast cancer cells. HER2-positive cancer responds to specific HER2-targeted therapies.
- PIK3CA gene mutation: If a tumor is hormone receptor-positive and HER2-negative, your provider may test for this gene mutation. Specific targeted therapies can be used to treat tumors with this mutation.
- PD-L1 status: Tumors that are hormone receptive-negative and HER2-negative may be tested for PD-L1 status. If the PD-L1 test is positive, you may be recommended to receive a combination of immunotherapy and chemotherapy.
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Treatment For Advanced Breast Cancer
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:
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.
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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.
Clinical Manifestations Of Stage 4
The main classification signs of breast cancer stage 4 are its spread to remote organs or lymph nodes. The size of the tumor at this stage is no longer important; moreover, it may no longer be detected at the primary site.
It is the metastases that most often develop in the liver, lungs, and bones that give information about the development of the oncological process. They are painful and cause vivid symptoms. Metastases in the liver give jaundice and increase abdominal size. Metastases in the lungs give shortness of breath, and in the bones severe pain and frequent fractures.
- severe intoxication;
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When Do People Get A Metastatic Breast Cancer Diagnosis
Metastatic breast cancer can occur at different points:
- De novo metastatic breast cancer: About 6% of women and 9% of men have metastatic breast cancer when theyre first diagnosed with breast cancer.
- Distant recurrence: Most commonly, metastatic breast cancer is diagnosed after the original breast cancer treatment. A recurrence refers to the cancer coming back and spreading to a different part of the body, which can happen even years after the original diagnosis and treatment.
How Is Metastatic Breast Cancer Diagnosed
If you have symptoms of metastatic breast cancer, your provider may recommend tests including:
- Blood tests, including complete blood count and comprehensive metabolic panel.
- Imaging studies, including MRI, CT, bone scan and PET.
- Bronchoscopy, which uses a scope to look inside your lungs this can be done if there is a concerning spot in the lungs.
- Biopsy to remove tissue from a suspicious area and analyze it.
- A tap to remove fluid from an area with symptoms. For example, pleural tap removes fluid from the lung area. Spinal tap removes fluid from the spinal cord area.
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Recurrence Of Metastatic Breast Cancer
Metastatic breast cancer is considered a chronic disease, so it doesnt go away and recur.
But in recent years, people under age 50 have seen a particularly strong decline in death rates due to breast cancer, according to the Centers for Disease Control and Prevention .
These declines are due in part to improved screening and treatment for the disease.
There are a few general facts that are helpful to know about breast cancer outlook:
- Breast cancer is the most common cancer diagnosis in the United States, according to the
Warning Signs And Words To Know
The most common symptom or warning sign of breast cancer is a lump in the breast. But both Cance and Cruz said not all lumps are cancerous. Women should also watch for nipple discharge and changes in breast shape or size.
Cance says vocabulary such as local, regional or distant may be used to describe a patient’s diagnosis. Local refers to the area where the cancer is confined within the breast. Regional may be used when the lymph nodes, primarily those in the armpit, are involved. The term distant is used when the cancer is found in other parts of the body as well, according to Cance.
Another term typically introduced after a breast cancer diagnosis is T-N-M. T represents the tumor size; N relates to the involvement of nearby lymph nodes; and M refers to whether the cancer has spread beyond the breast, according to Memorial Sloan Kettering Cancer Center.
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What Does It Mean To Have Metastatic Or Stage 4 Breast Cancer
After hearing a diagnosis of metastatic breast cancer, a rush of questions emerges. But often, its not until long after leaving the doctors office.
Metastatic means the cancer has spread beyond the breast and immediate lymph nodes to other organs or tissues in the body, most often the bones, brain, lungs or liver. Its considered stage 4 breast cancer, which means the cancer has progressed to its most advanced stage.
But even though its moved to other organs, it still behaves like breast cancer and is treated with breast cancer therapies.
More than 154,000 U.S. women are estimated to have metastatic breast cancer, according to the Susan G. Komen organization. Men can have metastatic breast cancer too, but its rare.
To help patients fill in information gaps, N. Lynn Henry, M.D., Ph.D., the breast oncology disease lead for the University of Michigan Rogel Cancer Center, explains the nuances of stage 4 metastatic breast cancer.
What Are The Differences Between Metastatic Breast Cancer Stage 4 Breast Cancer And Advanced Cancer
“Most of us use the names stage 4 and metastatic interchangeably,” Henry says. “Advanced is a little more complicated. Sometimes you will see the word ‘advanced’ used to describe metastatic cancer. But sometimes you will see the term ‘locally advanced.’ That means there’s a lot of cancer in the surrounding lymph nodes, but it doesn’t necessarily mean we see cancer that has spread outside of the area. We tend to stay away from the word ‘advanced’ because there can be confusion.”
If any doctor uses the term “advanced,” ask for clarification, Henry adds.
Every patient is different. In most cases, it arises months or years after a person has completed treatment for the initial breast cancer diagnosis, Henry says.
But some patients will learn they have metastatic breast cancer when first diagnosed, a term known as de novo metastatic breast cancer, Henry says. Only 6% of women and 8% of men receive a de novo metastatic diagnosis, according to Komen.
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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.
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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Stage 4 Breast Cancer: Prognoses And Solutions
Breast cancer cases have doubled in the last 20 years. Women die more often from this disease than all other cancers. Cancers develop inside our bodies, from our own cells that have mutated for some reason. Scientists all over the world have been fighting over the cause of cancer for decades and have come to the conclusion that the diseases destructive mechanisms are triggered by not one but many factors.
Types Of Breast Cancer
There are several types of breast cancer, and any of them can metastasize. Most breast cancers start in the ducts or lobules and are called ductal carcinomas or lobular carcinomas:
- Ductal carcinoma. These cancers start in the cells lining the milk ducts and make up the majority of breast cancers.
- Lobular carcinoma. This is cancer that starts in the lobules, which are the small, tube-like structures that contain milk glands.
Less common types of breast cancer include:
Inflammatory breast cancer is a faster-growing type of cancer that accounts for about 1% to 5% of all breast cancers.
Pagets disease is a type of cancer that begins in the ducts of the nipple.
Breast cancer can develop in women and men. However, breast cancer in men is rare. Less than 1% of all breast cancers develop in men.
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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.
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Doherty first revealed her cancer diagnosis in 2015 and shared that her cancer went into remission in 2017. But in February 2020, Doherty said her cancer had returned and it was stage IV, meaning that it had likely spread to other parts of her body.;
Of course, different people have different experiences with cancer depending on the type, stage, and other factors. The symptoms of cancer at this advanced stage are typically related to where the cancer is in the body, the National Cancer Institute explains. For instance, someone whose cancer has spread to their lungs may have shortness of breath, and symptoms such as headaches and dizziness may be caused by cancer in the brain. But stage IV cancer doesnt always come with noticeable symptoms, and, again, everyones experience can be different.
In Dohertys new movie, List of a Lifetime, the main character is diagnosed with breast cancer, reconnects with her daughter, and makes a bucket list. But Doherty isnt interested in making bucket lists of her own. Im very much like theres no bucket list because Im going to be the longest-living person with cancer, she said. If I had to say one, it would just be living. Thats the only thing on my list at this point.
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