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Stage 4 Triple Positive Breast Cancer

The Biology Of The Tumor

First Chemo-Infustion For Stage 4 Triple Negative Breast Cancer Pt. 2

Many tests will be done on a sample of the metastatic tumor . The results of these tests give information on the biology of the tumor that help guide treatment.

Which tumors are tested?

What does the tumor test determine?

How do the test results guide treatment?

All tumors

Hormone receptor status

If the cancer is hormone receptor-positive, the first treatment is usually hormone therapy, often with a CDK4/6 inhibitor.

All tumors

HER2 status

If the cancer is HER2-positive, HER2-targeted therapies, such as trastuzumab , are included in the treatment plan.

Tumors that are both hormone receptor-positive and HER2-negative

Whether the tumor has a PIK3CA gene mutation

If the tumor has a PIK3CA gene mutation, the cancer may be treated with the PI3 kinase inhibitor alpelisib , in combination with the hormone therapy fulvestrant.

PD-L1 status

If the cancer is PD-L1-positive, the first treatment may be the immunotherapy drug pembrolizumab in combination with chemotherapy.

Adapted from National Comprehensive Cancer Network , 2022

The NCCN has an animated video on these tumor tests.

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.

The Risk Of Metastatic Breast Cancer

The risk of metastasis after breast cancer treatment varies from person to person. It depends on:

  • The biology of the tumor
  • The stage at the time of the original diagnosis
  • The treatments for the original cancer

Modern treatments continue to improve survival for people with metastatic breast cancer. However, survival varies greatly from person to person.

About one-third of women diagnosed with metastatic breast cancer in the U.S. live at least 5 years after diagnosis . Some women may live 10 or more years beyond diagnosis .

Your oncologist can give you some information about your prognosis, but they dont know exactly how long you will live.

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Finding Social And Emotional Support

Its critical to find a strong source of social support, whether its your friends and family, or a support group with other people with breast cancer. While the journey is challenging, you dont have to navigate stage 4 breast cancer alone.

Ask your healthcare provider if theres an in-person support group where you receive treatments. You can also find online and social media groups to join.

Your healthcare provider can also provide more information about the specifics of your cancer, treatment options, and support programs in your area. If youre not sure where to look for an in-person group, a counselor or social worker can also help.

Can Metastatic Breast Cancer Go Into Remission

What You Need to Know About Breast Cancer

Metastatic breast cancer may never go away completely. But treatment can control its spread. Cancer may even go into remission at some points. This means you have fewer signs and symptoms of cancer.

A treatment break may be considered in certain situations, including if remission occurs or if someone is experiencing intolerable side effects. A pause in treatment can help you feel your best and improve your quality of life.

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Metastatic Breast Cancer Treatment

As hard as it is to hear, metastatic breast cancer cannot be cured today. Unlike breast cancer that remains in the breast or nearby lymph nodes, medical treatments cant get rid of all the cancer thats spread to other parts of the body.

However, metastatic breast cancer can be treated. Treatment focuses on extending life and maintaining quality of life.

Your treatment plan is guided by many factors, including:

  • The biology of the tumor
  • Where the cancer has spread
  • Your overall health, age, menopausal status and other medical issues
  • Personal goals and preferences

Learn more about getting a second opinion.

Susan G. Komen®s Metastatic Breast Cancer Impact Series

Susan G. Komens free MBC Impact Series provides people living with metastatic breast cancer and their loved ones a safe, space to gather information related to MBC and discover practical resources to help make decisions for improved physical and emotional health. To learn more and register visit

Stage Iv Breast Cancer Treatment Options

With stage IV, the breast cancer has spread to other parts of your body. Often the bones, brain, lungs, or liver are affected. Because multiple areas may be involved, focused treatments like surgery or radiation alone may not be enough.

Treatment of stage IV doesnât cure the disease. But by shrinking the cancer, it can often slow it down, help you feel better, and let you live longer. Patients with stage IV breast cancer may live for years, but itâs usually life-threatening at some point.

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What Treatments Are Used For Metastatic Cancer

Metastatic cancer may be treated with chemotherapy, biological therapy, targeted therapy, hormonal therapy, radiation therapy, surgery, or a combination of these treatments.

The choice of treatment generally depends on the type of primary cancer the size, location, and the number of metastatic tumors. Also, the patients age and general health and the types of treatment the patient has had in the past.

Her2+ Status Cancer Stage And Survival

Ask the expert: Triple-negative breast cancer with Rita Nanda, MD

The importance of HER2 status for survival will depend on how far the cancer has spread. If itâs only in the breast, then it wonât make much difference. Most women in the early stage of the disease do well because a surgeon can remove the tumor.

Itâs when a breast tumor grows and spreads to lymph nodes or farther away in the body that HER2 status becomes more important for treatment and survival. Thatâs because there are now drugs that target HER2, but these work only for cancers that are HER2+. A common drug for HER2+ breast cancer is trastuzumab , but there are others. Because there are more treatments, women with more advanced HER2+ breast cancers today will on average have better survival rates than those with more advanced HER2- breast cancers.

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Which Is The Most Aggressive Form Of Breast Cancer

The most aggressive and serious type of breast cancer is metastatic breast cancer. Metastatic disease means the cancer has spread from the original tumor site to other parts of the body. Metastatic breast cancer, also called stage 4 breast cancer, has spread from the breast to other parts of the body, such as the liver, lungs, bones, or brain.

In terms of hormone receptor status, triple-negative cancer cells are more aggressive, tend to occur in younger patients, are often diagnosed at later stages, and are more likely to metastasize. Breast cancers that are HER2-positive also tend to be aggressive with lower survival rates. They frequently do not respond to hormonal therapy. However, triple-positive breast cancers that are estrogen receptor-positive, progesterone receptor-positive, and HER2 positive behave more like ER-positive and HER2-negative tumors. They tend to be less aggressive and more responsive to endocrine therapy . Nonetheless, tumors that are triple positive tend to be more aggressive than those that are ER-positive alone.

In general, cancer cells that are estrogen receptor-positive alone have the best prognosis or outcomes, followed by triple positive cancer cells, HER2 positive tumors, and triple-negative tumors .

Keep in mind that each patient is unique, and their cancer can behave unexpectedly. Doctors can, however, provide a prognosis based on the tissue sample, imaging, lymph nodes, metastasis, and other factors.

Is Chemo Necessary For Triple

Triple positive breast cancers are treated with chemotherapy, neoadjuvant chemotherapy, surgery, radiation therapy, hormone drugs, and targeted therapy . The medical team develops an individualized treatment plan for each patient based on various factors, including the tumors hormone receptor expression. Initial treatment may consist of surgery followed by other modalities.

The National Comprehensive Cancer Network has a range of free resources for patients who wish to learn more about treatment options for their breast cancer.

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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.

Treatment Guidelines For Metastatic Breast Cancer

What is the life expectancy of someone with stage 4 metastatic breast ...

Although the exact treatment for metastatic breast cancer varies from person to person, guidelines help ensure high-quality care. These guidelines are based on the latest research and agreement among experts.

The National Comprehensive Cancer Network and the American Society of Clinical Oncology are respected organizations that regularly review and update their guidelines.

In addition, the National Cancer Institute has treatment overviews.

The Centers for Disease Control and Prevention recommends people with cancer and their caregivers get the seasonal flu shot.

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Faith In The El Camino Health Cancer Care Team

Through it all, Carol drew strength from knowing she had an entire team in her corner fighting her cancer. In fact, she says she cant begin to describe how much she has grown to love everyone at the El Camino Health Cancer Center.

The whole team is amazing, she says. Dr. Dormady and nurse practitioner Katie are the best! They put up with my questions and quirks with the best humor and love. They understood my desire to be treated but not overtreated.

The nurses are like family. I have to give a shoutout to my nurse Hannah. We shared our lives together every week for a whole year. That was the biggest blessing ever. I still drop by with treats when Im in the area as an excuse to say hi.

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.

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Carol: My Year Of Treatment For Triple Positive Breast Cancer

In the third trimester of her first pregnancy, Carol was scratching at the pregnancy rash covering her body when she felt a lump in her breast. At her biweekly checkup, she brought it to the attention of her El Camino Health obstetrician Dr. Maureen Khoo, who immediately ordered an ultrasound. A biopsy confirmed triple-positive breast cancer.

“I was so stunned and shocked,” says Carol, who remembers the first part of her cancer journey as a crazy time. “They induced my baby at 39 weeks so we could start treatment. The day I checked out of the hospital after giving birth, I checked back in to finish my scans.”

Carol was grateful that the El Camino Health scheduling staff took charge of the details, shepherding her along to each of her appointments. When it was time to talk about treatment options, she met with top oncologist Dr. Shane Dormady.

Recurrent Breast Cancer: Facts And Figures

Triple positive breast cancer patient doing well after treatment by Loyolaâs multidisciplinary team

Breast cancer can return at any point after the initial diagnosis and treatment. This is one of the most anxiety-provoking factors for many women after breast cancer diagnosis and treatment.

There are 3 types of cancer recurrence:-

  • Localized: The cancer returns to the original site where it started.
  • Regional: The cancer has spread to nearby lymph nodes, tissues or organs
  • Distant: The cancer has spread to distant body sites such as the bone, brain, liver or lungs.
  • It is very difficult to predict how many breast cancers of all stages recur, at local, regional and distant sites.

    Indeed, breast cancer incidence and mortality rates are documented over the years. However, data on most cancer registries do not document the incidence of recurrence.

    Furthermore, a local or regional recurrence does not have the same prognostic impact as distant metastasis. Even more difficult to handle, is that cancer can recur at any given point in time.

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    Detecting Breast Cancer With Screening And Awareness

    One of the best ways to improve your chances of surviving breast cancer is to be vigilant about getting routine screenings for the disease. The earlier cancer is found, the better the outlook. According to the ACS, screening reduces breast cancer deaths by 20%. The ACS says that women at average risk for breast cancer should have the option of starting annual screening mammograms between ages 40 to 44 years, while women ages 45 to 54 years should have annual mammograms. Starting at age 55, women should have the option of receiving a mammogram every year or every two years, the ACS says.

    Dr. Cairoli points out that younger women who arent covered by screening recommendations should not assume theyre not susceptible to breast cancer. Unfortunately, theres no such thing as too young. Breast cancers can occur in patients even in their 20s. He recommends that all women, especially those not yet of screening age, perform monthly breast self-examinations.Monthly breast self-exams havent been shown to improve outcomes for the population at large, but by knowing your body youll be able to alert your physician if you notice a change, Dr. Cairoli says. And if you do find something unusual, he adds, insist on a physical examination or screening even if your doctor tries to tell you youre too young for breast cancer.

    Breast cancer symptoms to be alert for include:


    To learn more about RCCA, call 844-928-0089 or visit

    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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    Request An Appointment At Moffitt Cancer Center

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    How Is The Stage Determined

    Breast Cancer: IDC, Triple Negative, Stage 2B/4 Metastatic

    The staging system most often used for breast cancer is the American Joint Committee on Cancer TNM system. The most recent AJCC system, effective January 2018, has both clinical and pathologic staging systems for breast cancer:

    • The pathologic stage is determined by examining tissue removed during an operation.
    • Sometimes, if surgery is not possible right away or at all, the cancer will be given a clinical stage instead. This is based on the results of a physical exam, biopsy, and imaging tests. The clinical stage is used to help plan treatment. Sometimes, though, the cancer has spread further than the clinical stage estimates, and may not predict the patients outlook as accurately as a pathologic stage.

    In both staging systems, 7 key pieces of information are used:

    • The extent of the tumor : How large is the cancer? Has it grown into nearby areas?
    • The spread to nearby lymph nodes : Has the cancer spread to nearby lymph nodes? If so, how many?
    • The spread to distant sites : Has the cancer spread to distant organs such as the lungs or liver?
    • Estrogen Receptor status: Does the cancer have the protein called an estrogen receptor?
    • Progesterone Receptor status: Does the cancer have the protein called a progesterone receptor?
    • HER2 status: Does the cancer make too much of a protein called HER2?
    • Grade of the cancer : How much do the cancer cells look like normal cells?

    In addition, Oncotype Dx® Recurrence Score results may also be considered in the stage in certain situations.

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    A Note About Sex And Gender

    Sex and gender exist on spectrums. This article will use the terms, male, female, or both to refer to sex assigned at birth. .

    Stage 4 breast cancer occurs when cancerous cells spread to other areas of the body beyond the breast and local lymph nodes.

    The American Cancer Society notes that breast cancer most commonly spreads to the lungs, liver, and bones. It can also spread to other organs, including the distant lymph nodes, skin, and brain.

    A doctor may diagnose stage 4 breast as either a new case, referred to as de novo, or as a recurrence of a previous breast cancer.


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