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.
Why Does Metastatic Breast Cancer Happen
Most often, metastatic cancer occurs because treatment didnt destroy all the cancer cells. Sometimes, a few cells remain dormant, or are hidden and undetectable. Then, for reasons providers dont fully understand, the cells begin to grow and spread again.
De novo metastatic breast cancer means that at the time of initial diagnosis, the breast cancer has already spread to other parts of the body. In the absence of treatment, the cancer spreads.
There is nothing you can do to keep breast cancer from metastasizing. And metastatic breast cancer doesnt happen because of something you did.
Andrew And Traceys Story
All the statistics only talk about the number of women affected what they dont mention is the effect on the people that love them parents, children, siblings, extended family, friends. My wife, Tracey, was diagnosed with breast cancer in late 2010 and was told it had spread to her liver and lung in 2012. Firstly, theres the pain that you have to watch your partner go through the ongoing pain from metastasis the spread of the cancer from her breasts to her spine, ribs, liver and lung. Secondly theres the fear. Fear of losing her sooner rather than later and being alone. Andrew, Husband of Tracey, diagnosed 2010.
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Clinical Trials Are A Promising Treatment Option
For people with advanced stages of cancer, clinical trials can be considered the gold standard of treatment. I recommend clinical trials highly, says Rosen. You get access to medication and treatment that you normally wouldnt have.
A clinical trial could even have positive results on your cancer. We are living in an exciting time for cancer treatment, says Kimmick. There are myriad new drugs coming out that will improve the lives of all women with breast cancer, both metastatic and early stage.
However, its important to be realistic about the potential outcome of your trial. Rosen was recently enrolled in a clinical trial in which the medication proved toxic for her. But she has no regrets about participating. It feels like Im helping researchers who are working on cures for cancer, she says. When I had a bad reaction to the drug, they were able to put my side effects in their study. I feel like I did help, and that makes me happy.
People interested in joining a clinical trial for treatment should talk to their doctor about options that might be good for them.
Four Things To Remember When You Hear The Words You Have Stage 4 Cancer
As Cancer Fighters volunteers, Ed and his wife Sandy set a goal to use encouragement, education and empowerment to change others initial reaction to the words, You have cancer. Now, Ed and Sandy are sharing the four pieces of advice that helped their family navigate a metastatic cancer diagnosis.
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Treatments For Metastatic Triple
One myth about treating TNBC is that there arent effective treatment options. The truth is that an array of treatments can improve your care. Your treatment options include many medicines and may also include targeted therapies that treat some triple-negative breast cancers with specific features.
How do you choose from the many available chemotherapy options? It is important to talk with your doctors about how you wish to balance the goals of keeping the cancer under control as long as possible and maintaining your ,or overall enjoyment of life.
Another important point about treating metastatic TNBC is that if you had early- disease, you can retry medicines you were treated with before. A certain treatment may have failed to get rid of the primary disease, but that treatment could still control it in the metastatic setting.
Common chemotherapy treatments for metastatic triple-negative disease are:
- , which kill cancer cells by stopping growth. Three anthracyclines used in metastatic breast cancer are:
What Is Stage Iv Breast Cancer
Stage IV is the most advanced stage of breast cancer. It has spread to nearby lymph nodes and to distant parts of the body beyond the breast. This means it possibly involves your organs such as the lungs, liver, or brain or your bones.
Breast cancer may be stage IV when it is first diagnosed, or it can be a recurrence of a previous breast cancer that has spread.
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Can You Fully Recover From Stage 4 Breast Cancer
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 Risk Of Breast Cancer Spreading To The Brain
Brain metastasis. The risk of breast cancer spreading to the brain is generally highest in those with HER2-positive or triple-negative breast cancer, which are more aggressive subtypes of this disease. About 1015 percent of women with stage 4 breast cancer will develop brain metastasis. Symptoms include: a headache.
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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.
Will I Need More Than One Treatment For Metastatic Breast Cancer
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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Living With Metastatic Breast Cancer
It can be upsetting for you, your family, and other loved ones to learn that breast cancer has spread to other areas of the body. But there are ways to manage your feelings, get support, figure out how to talk about the diagnosis with family and friends, and work after being diagnosed.
Its not always easy to balance your sexual needs with the physical and emotional challenges of a metastatic breast cancer diagnosis. You can manage the sexual issues that can often come up with a metastatic breast cancer diagnosis.
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Advanced Cancer That Progresses During Treatment
Treatment for advanced breast cancer can often shrink the cancer or slow its growth , but after a time, it tends to stop working. Further treatment options at this point depend on several factors, including previous treatments, where the cancer is located, a woman’s menopause status, general health, desire to continue getting treatment, and whether the hormone receptor status and HER2 status have changed on the cancer cells.
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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.
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, theres no way to know a person has the disease until outward signs appear. Usually, youll 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.
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Can Stage 4 Breast Cancer Go Into Remission
Stage 4 breast cancer can go into remission, meaning that it isnt detected in imaging or other tests. Pathological complete remission indicates a lack of cancer cells in tissues removed after surgery or biopsy.
But its rare to take tissue samples while treating stage 4 breast cancer. This could mean that although treatment has been effective, it hasnt completely destroyed the cancer.
Advances in stage 4 breast cancer treatments are helping to increase the length of remission.
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.
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Palliative Care Is Looking Out For Me
I have been living with cancer for 10 years. I have bone and brain metastases, which are stable.
This year has been my biggest challenge, with fractures occurring in my femurs due to a side effect of a bone density drug. Consequently, I now have rods in both femurs and endured two major setbacks due to refracturing around the rods. I have been in a world of pain, and while I was in care in hospital, I was referred to my local palliative care organisation.
Even though I havent had another acute incident, I know that my body is starting to break down and Im comforted and relieved that palliative care is looking out for me to help me manage pain and symptoms so I can continue to live life as well as possible.
This service is free and involves a multidisciplinary team. Thus far I have met a nurse, social worker and occupational therapist. I havent needed them yet, but its so good to have them if my illness progresses.
I see them as an extension of my medical team at home. They have brought up issues in relation to developing a health plan and end of life plan for me and my family. It was done in a very compassionate way and has seeded the thought of organising the next phase in my journey to reduce the trauma for my family and myself.
How Does Chemotherapy Work
Chemotherapy. Chemotherapy uses one or more drugs to kill cancer cells and slow cancer growth. The drugs are taken orally or intravenously. Afterward, they travel through the bloodstream. This way, the drugs can target the original site of the cancer as well as areas in the body where the cancer cells have spread.
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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.
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Looking For More Of An Introduction
If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net:
ASCO AnswersFact Sheet: Read a 1-page fact sheet that offers an introduction to metastatic breast cancer. This free fact sheet is available as a PDF, so it is easy to print.
ASCO AnswersGuide:Get this free 52-page booklet that helps you better understand breast cancer and its treatment options. The booklet is available as a PDF, so it is easy to print.
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What Treatment Options Are Available For Stage Iv Cancer
Treatment for stage IV depends on the location of the cancer and the organs involved. The more widely the cancer has spread from the site where it was first diagnosed, the more difficult it becomes to treat. Patients diagnosed with stage IV or metastatic cancer may not survive long without treatment.
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 casesthere 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.
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