Additional File : Figure S3
Cumulative incidence curves of deaths to show the probability of each competing event in the entire cohort and according to metastatic sites . The real line represents breast cancer-specific mortality and the dotted line represents competing mortality. Cumulative incidence curves of deaths to show the probability of death due to breast cancer according to metastatic sites .
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.
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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Breast Cancer Subtypes Hormonal And Her2 Status
Although the term breast cancer is used in general, there are many different sub-types of breast cancers. The sub-types behave in different ways, with some responding better to treatments and some growing and spreading at faster rates.
Obviously, the sub-type of breast cancer affects survival rates.
There are 5 molecular types of breast cancer:-
What I Wish People Knew About Metastatic Breast Cancer
Women with metastatic breast cancer think about fighting cancer very differently than women who dont 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.
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What Are The Symptoms Of Breast Cancer Recurrence
You may experience different signs of breast cancer recurrence depending on where the cancer forms.
Local breast cancer recurrence may cause:
- Breast lump or bumps on or under the chest.
- Nipple changes, such as flattening or nipple discharge.
- Swollen skin or skin that pulls near the lumpectomy site.
- Thickening on or near the surgical scar.
- Unusually firm breast tissue.
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Stage 4 Small Cell Lung Cancer
The second most-common type of lung cancer after NSCLC is small cell lung cancer . SCLC is not typically grouped into numbered stages. Instead, its identified as limited stage or extensive stage.
- With limited-stage SCLC, the cancer is present in one lung and may have spread to lymph nodes near that lung, but its contained to one side of the chest. If the lung has multiple tumors, the cancer may not be in the limited stage.
- Extensive-stage SCLC is similar to stage 4 NSCLC in that it is metastatic. SCLC is considered extensive if it has spread throughout the original lung, into the other lung or faraway lymph nodes, or to any other areas of the body.
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Living With Metastatic Breast Cancer
An advanced breast cancer diagnosis often elicits a flood of emotions: fear, confusion, sadness, anger and worry. You may wonder, Why me? You may think its unfair that this has happened to you. All of these emotions and feelings are normal, so take the time to process your thoughts, speak with your care team to understand your diagnosis, and connect with loved ones and close friends for support.
Over time, as the shock wears off, many patients find that they get on with their lives, adjusting to what some call their new normal. You may continue to work, enjoy life and spend time with family and friends, even if sometimes you have less energy than before.
Try to eat a nutritious diet to feel stronger and better tolerate treatments. Maintaining good nutrition may also help lower your risk of infection and provide you with more energy for enjoying life.
Light exercise may give your mind and body’s boost, helping you feel energized, especially if you spend time in the fresh air. Always seek medical advice before making any changes to your diet or exercise routines.
What Is Secondary Breast Cancer In The Lung
Secondary breast cancer in the lung happens when breast cancer cells spread to the lung. It can also be known as lung metastases or secondaries in the lung.
Secondary breast cancer in the lung is not the same as cancer that started in the lung.
Usually secondary breast cancer occurs months or years after primary breast cancer. But sometimes its found at the same time as the primary breast cancer, or before the primary breast cancer has been diagnosed. In this situation, the breast cancer has already spread to the other parts of the body such as the lung. This is referred to as de novo metastatic breast cancer, meaning the breast cancer is metastatic from the start.
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Cancer Care Team / Pain Clinics
If youre looking for support during this time, working with your oncologist and cancer care team can be helpful. Many teams include a patient navigator who is assigned to guide you through the different stages of your diagnosis and connect you to helpful resources that can assist you.
Pain clinics, or palliative care, is another option. Your palliative care team is there to support you by treating and preventing the painful and uncomfortable side effects that can result from certain forms of cancer treatment.
Newly Diagnosed Or Worried About A Symptom
In the days or weeks after a diagnosis of secondary breast cancer, you may feel distressed and find it hard to think clearly.
You can read our information for people newly diagnosed with secondary breast cancer, including where to find support.
If you havent been diagnosed but are worried about a symptom, find out more about the signs and symptoms of secondary breast cancer.
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Breast Cancer Metastasis: Secondary Sites
Over the years there have been significant improvements and advancements in the diagnosis and treatment of breast cancer. Indeed, breast cancer is now considered to be a manageable disease.
However, there are still over half a million deaths worldwide from breast cancer and over 90% of these women die of metastasis. Consequently, research into metastasis is of vital importance in overcoming deaths from metastatic breast cancers.
Stage IV or metastatic breast cancer, as mentioned earlier, are cancer cells that have spread from the breast to distant sites around the body. Common secondary sites are:-
- Bone: .
- Lungs
- Liver
What Is Breast Cancer Staging
Breast cancer staging is the determination of the extent and spread of the cancer. An individual’s health care team uses stages to summarize the extent of the cancer in a standardized way that is recognized by all health care providers. They use this staging to determine the treatment most appropriate for the type of cancer. Cancer staging helps to determine the prognosis, or outlook, of a cancer, including rates of recurrence and survival rates.
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How Life Expectancy And Relapse Differ From Positive Tumors
Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.
Questions about the survival rate and recurrence rate are very common when someone is diagnosed with triple-negative breast cancer. While prognosis is, on average, poorer than with hormone receptor or human epidermal growth factor receptor 2 positive tumors, triple-negative breast cancer is a very diverse disease.
On a positive note, and unlike hormone-positive tumors that commonly recur late , late recurrence is less common with triple-negative tumors. The recent approval of immunotherapy only for triple-negative disease is also optimistic.
This article looks at factors that may affect survival or recurrence of triple-negative breast cancer, as well as the statistical rates of both. It also discusses life expectancy with stage 4 and recent case reports of some longtime survivors.
What Are The Survival Rates For Stage 4 Lung Cancer
Stage 4 lung cancer survival rates measure how many people are living a certain number of years after they were diagnosed with stage 4 lung cancer.
For example, a 5-year survival rate of 6 percent means that people with stage 4 lung cancer are, on average, about 6 percent as likely to survive for at least 5 years as people who dont have lung cancer.
Cancer survival rates are based on statistics from the NCIs Surveillance, Epidemiology, and End Results Program database.
Keep in mind that survival rates are only estimates. Everyones body responds to the disease and its treatment differently.
Relative survival rates also dont take into account recent improvements in treatment. Theyre based on diagnosis and treatment from at least 5 years earlier. New treatments are being researched and improved on every day.
The following provided by the ACS are based on people who were diagnosed with stage 4 lung cancer between 2010 and 2016.
| Stage |
The treatment options for late stage 4a or 4b lung cancer vary depending on several factors, such as:
- how far the cancer has spread
- whether any gene mutations have occurred
- your health in general
Before treatment for stage 4 lung cancer starts, your tumor may be tested for genetic mutations. According to a 2015 research review , one of these mutations is in the EGFR gene. If the gene is mutated in your cancer cells, you may receive a targeted therapy drug.
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I May Not Feel Like A Fighter Theres No Final Victory
The language used to describe cancer and its treatment is often the language of war: fighting cancer, battling cancer, being a warrior. But those words may not resonate with women who have metastatic breast cancer.
Sendelbach recalls using fighting words when she was first diagnosed with stage 1 breast cancer. I was 30 years old, and I was in fight mode, she says. I was like, Hell yeah, I can kick cancers ass and so on. When she was diagnosed with stage 4, though, she realized there would be no end in sight, no final victory for her.
Theres not a finish line, she says, so to be in fight mode doesnt really work. There has to be an end in sight to stay in that place.
For her, metastatic breast cancer is something she deals with day to day. She describes her journey as a marathon, not a sprint. If you have to stop sometimes to walk and take water breaks, she says, you should. If you try to run as fast as you can all the time, its inevitable that youre going to fail.
Binet And Rai Systems
Binet and Rai are the staging systems used to specifically diagnose Chronic LymphocyticLeukemia , a non-tumorous cancer of the blood and bone marrow. Both of these systems use the patients white blood cell count to determine how far their cancer may have spread and what areas of the body are being affected.
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How Long Can Someone Live With Stage 4 Cancer
Doctors usually describe a persons outlook using the 5-year survival rate. These are calculated based on data from thousands of other people with a similar cancer at a similar stage.
The original location of the cancer determines its type. Survival rates vary, depending on the type of cancer and how far it has spread within the body.
Below, we describe the survival rates for some of the most common forms of cancer in stage 4:
Many Women Live For Decades With Metastatic Breast Cancer
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.
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Stage 4 Patients Can Live For Years
The 5 year survival rates listed in the chart above are NOT intended to scare you, but rather to inform you of the average, approximate ratesfor each type of cancer we have explored in this article. The fact is, Stage 4 cancer patients can live for YEARS, and these statistics are just that, statistics. They do not define your experience and do not mean that you cannot beat cancer and thrive!
Statistics Dont Account For Late Recurrences
When comparing triple-negative breast cancer to positive tumors, its important to keep in mind late recurrences. Most statistics are presented as five-year survival rate, and in this setting, triple-negative breast cancer can look more ominous. But looking at longer periods of time, say 20 years following diagnosis, this may be different.
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How Breast Cancer Spreads To The Lungs
Breast cancer starts in the breast. As the abnormal cells divide and multiply, they form a tumor. As the tumor grows, cancer cells can break away from the primary tumor and travel to distant organs or invade nearby tissue.
Cancer cells can enter the bloodstream or migrate to nearby lymph nodes under the arm or near the collarbone. Once in the blood or lymph systems, cancer cells can travel through your body and land in distant organs or tissue.
Once cancer cells reach the lungs, they can start to form one or more new tumors. Its possible for breast cancer to spread to multiple locations at the same time.
What Are Cancer Survival Statistics
A key part of making a prognosis is looking at survival rates. These are numbers researchers collect over many years in people with the same type of cancer. These numbers are based on large groups of people. For breast cancer, there are two main measurements:
Breast cancer survivalrates reflect the percentage of women who are alive 5 years or longer after their diagnosis. This means the numbers are based on women who were found to have breast cancer at least 5 years ago. Advances in diagnosing and treating cancer have led to steadily improving survival rates, so the outlook for women diagnosed today is likely better.
Relative survival rates donât take into account the cause of death. Theyâre a measure of the percentage of people with cancer who have lived for a certain time after diagnosis, compared with people who did not have cancer.
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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.