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What Happens When Breast Cancer Spreads To The Bones

Symptoms Of Secondary Breast Cancer

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Secondary breast cancer means that a cancer that began in the breast has spread to another part of the body. Secondary cancer can also be called advanced or metastatic cancer.

It might not mean that you have secondary breast cancer if you have the symptoms described below. They can be caused by other conditions.

How Is Metastatic Breast Cancer Treated

The main treatment for metastatic breast cancer is systemic therapy. These therapies treat the entire body. Systemic treatments may include a combination of:

Your care team will plan your treatment based on:

  • Body parts cancer has reached.
  • Past breast cancer treatments.
  • Tumor biology, or how the cancer cells look and behave.

About Those Lymph Nodes

A surgeon will usually take a lymph node biopsy to determine if the breast cancer has spread to the axillary lymph nodes. This is not always necessary, however. A lymph node biopsy is not usually necessary for DCIS. However, for invasive breast cancer, yes, they do need to check the lymph nodes.

Sometimes, doctors will perform a sentinel node biopsy, rather than a full lymph node excisional biopsy if the concerns about cancer spread are minimal. Cancer cells tend to appear first in the sentinel node before spreading to the other nodes, or other areas of the body.

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Whats The Outlook For Metastatic Breast Cancer

The right treatment plan can improve survival for people with metastatic breast cancer. However, survival rates vary and are dependent on a number of factors including type/biology of the breast cancer, parts of the body involved and individual characteristics. About 1 in 3 women live at least five years after diagnosis. Some live 10 years or longer. Your care team will discuss your prognosis with you in more detail.

Treatment For Metastatic Breast Cancer

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There are a number of different approaches to treating metastatic breast cancer. Every cancer is unique and treatment can be tailored to your specific circumstances.

Doctors usually treat metastatic breast cancer in any part of the body with systemic medications, which treat cancer throughout the entire body. Chemotherapy, hormonal therapy, targeted therapies, and immunotherapy are all systemic medications. Local treatments that target a specific part of the body, such as surgery or radiation, are sometimes recommended.

Most treatment decisions depend on where in the body the cancer has spread, the cancers characteristics , and any cancer treatments youve had in the past.

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Metastasis And Bone Destruction

In 1995, Mundy and Yoneda described the cellular events necessary for the success of the metastatic process, including the attachment of tumor cells to the basement membrane, the production of proteolytic enzymes by tumor cells , and the migration of tumor cells through the basement membranes into surrounding tissue, especially the arteriolar network.

Cells from the primary site must, through the process of neovascularization or through migration to the nearest blood vessel, attach to the basement membrane of the vessel wall and produce proteolytic enzymes that disrupt the basement membrane.

The cells then migrate through the basement membrane and float away in the bloodstream to a distant site. The process through which these tumor cells are attracted to a specific site in the body is not completely clear, though type I collagen, a byproduct of bone resorption, has been shown to be a chemotactic factor that attracts tumor cells to bone.

If they survive the journey to the distant site, the tumor cells attach to the basement membrane of the vessel wall using proteolytic enzymes . After disrupting the receptor site basement membrane, they migrate into the substance of the distal host tissue. Producing chemotactic factors, as well as RANK ligand , these cells stimulate osteoclast activity, causing bone resorption and leading to the formation of pockets or holes in the bone in which the tumor cells grow.

Signs That Breast Cancer Has Spread To The Bone

Most aches and pains arent cancer, stresses Huston. But its important to keep an open and honest dialogue with your doctor about any unusual or persistent discomfort you may be having. He or she can determine if getting images is appropriate to rule out bone metastasis. Here are the symptoms of bone metastasis to look out for:

If you report any of the above symptoms to your doctor, he or she may want to do a thorough physical exam, blood tests, and a bone scan to check for bone metastasis. Depending on the results and where or how severe the bone pain is, he or she may also order an X-ray, PET scan, or CT scan. In some cases, a tissue biopsy is also done to confirm the diagnosis.

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How Effective Are Treatments For Bone Metastases

Although current treatments for bone metastases are unable to completely remove all cancer cells, many women with bone metastases can live for many years with extremely good quality of life.

The effect of bone metastasis on your prognosis is individual and depends on what type of cancer you have, where it has spread to and how you respond to various treatments. The main aim of any treatment is to control pain and other symptoms so you can enjoy your day-to- day activities as much as possible.

Stages Of Breast Cancer: Stage Iiic

Breast Cancer Metastasis, When Can It Happen?

Stage IIIc breast cancers basically involve tumors of any size with significant metastases to:-

  • the lymph nodes behind the sternum
  • lymph nodes under the arm
  • the lymph nodes above or below the collarbone

The extent and depth of lymph node involvement make these patients unsuitable candidates for surgical treatment as a primary mode of therapy. Chemotherapy is the treatment of choice for women with stage IIIb and IIIc breast cancers.

However, up to 70% of patients with stage III breast cancers who have chemotherapy remain alive and disease-free after 7 years.

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When Breast Cancer Spreads To Bone Why Is It Still Called Breast Cancer

When cancer spreads to a new place in the body, it has the same type of cancer cells as the original tumorand therefore the same name.1 For example, breast cancer that spreads to the bone is still breast cancer, not bone cancer. This is important because cancer treatment plans are based on where the cancer started.1

How Is A Local Recurrence After Lumpectomy Diagnosed

After a diagnosis of early stage breast cancer, any remaining breast tissue should be evaluated annually with scans .

Most local recurrences within the breast after lumpectomy are detected on routine annual breast imaging, which usually takes the form of mammography and ultrasound, and on occasions MRI.

If you have a local recurrence or new primary breast cancer, you may find symptoms similar to an initial breast cancer. This includes:

  • A new lump in the breast, armpit area or around the collarbone
  • A change in breast size or shape
  • Changes to the nipple, such as sores or crusting, an ulcer or inverted nipple
  • Clear or bloody nipple discharge
  • Changes to the skin including redness, puckering or dimpling
  • Breast tenderness or pain

Once a local recurrence has been diagnosed, we do tests to see whether there are signs of cancer elsewhere in the body. These may include a chest X-ray, CT scan, bone scan or PET scan, and blood tests , then we have to figure out how best to treat the tumour in the breast. Usually in these cases we do a mastectomy, as the prior less drastic surgery and radiation didnt take care of it.

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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.

Medications For Mild Bone Pain

Cancers Spread to Bone

Bone pain often responds to heat, or to mild pain relievers such as ibuprofen , naproxen or acetaminophen .

Although you can get these medications without a prescription, check with your health care provider before taking them. For example, if you have a low blood count, or your kidneys are not functioning normally, or you have heart failure, your health care provider may advise you not to take ibuprofen or naproxen.

Learn more about these medications in metastatic breast cancer care.

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How Can I Take Care Of Myself While Living With Metastatic Breast Cancer

Living with metastatic breast cancer can be challenging. Your care team can help provide physical and emotional support. Talk to them about how you can:

  • Eat the most nutritious diet for your needs.
  • Exercise regularly.
  • Get emotional support, including finding support groups.
  • Reach out for help from friends, family and loved ones.
  • Find mental health services.
  • Find complementary therapies.

Stage Ii Breast Cancer

There are basically four sub-categories of breast cancer within the category of stage II. Breast tumors in the Stage II classification are:

  • A breast tumor that is 2cm in diameter or less. BUT the cancer cells have already spread to the lymph nodes.
  • OR a breast tumor that is larger than 5 cm but has not yet spread to the lymph nodes.
  • OR breast tumors in between 2 cm and 5 cm in diameter -whether there is evidence of spread to the lymph nodes or not.

There are actually quite a number of specific subcategories and letters and numbers to indicate a more precise description of the breast cancer at Stage II. .

In summary, stage II breast cancer is of intermediate size and threatening to spread. Without a doubt, staging for stage II breast cancers requires a thorough investigation of potential metastases.

Survival Rates for Stage II Breast Cancer

The average survival rate for stage II breast cancers is about 93% after five years and about 75% after 10 years. The rate of local recurrence is about 16% for stage II breast tumors. Furthermore, only about 16% of stage II breast cancers either have or will develop lymph node metastasis.

See also our new up-to-date survival rates by stage OR our general survival rates for breast cancer

A baseline bone scan is unlikely to detect bone metastasis with stage 2 tumors, but they are usually necessary just to be sure.

Treatment for Stage II Breast Cancer

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What Investigations Are Necessary For Staging Breast Cancer

Breast cancer staging almost always involves a bone scan, as breast cancer is highly prone to metastasize to the bones.

During this test, medics inject a small amount of a radioactive substance into the bloodstream, where it eventually collects in the bones. A radiation scanner is then able to detect accumulations of tracer substance in the bones.

If breast cancer spreads beyond the breast, 25% of the time it goes into bones first.

Lymphangiogenesis And Lymphatic Metastasis

What Is Metastatic Breast Cancer?

While the promoting effect of angiogenesis and vascularization of the tumor in the progression of the disease is well documented, there is little information with regard to lymphangiogenesis and its function in metastasis. Certain studies have indicated that the tumors are devoid of lymphatic vessels, while others have suggested that tumors invade and destroy lymphatic vessels . Furthermore, other studies have indicated that tumor cells may induce lymphangiogenesis, some form of lymphatic sprouting, or hyperplasia in close proximity to the periphery of the tumors . Therefore, the pertinent question is whether lymphangiogenesis is necessary for lymphatic metastasis. Although it is possible for lymphatic metastasis to occur via preexisting vessels that were incorporated into the tumors, there is evidence to suggest that increased lymphatic vessel density due to lymphangiogenesis significantly improves metastasis .

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Symptoms When Breast Cancer Has Spread To The Bones

The main symptoms of breast cancer that has spread to bone are:

  • Pain particularly in the back, arms or legs, often described as gnawing which occurs when resting or sleeping, and may get worse when lying down especially at night
  • Fractures

Find out more about the symptoms of secondary breast cancer.

Other possible effects include:

Integrative Therapies For Metastatic Breast Cancer

You may find it beneficial to add integrative therapies to your treatment plan. There are many evidence-informed integrative modalities to boost the mind and body. Practices like gentle yoga, meditation, massage and music therapy may feel enjoyable and reduce stress and anxiety levels.

To help our patients maintain quality of life after a metastatic breast cancer diagnosis, our team of breast cancer experts may offer supportive care services to help manage side effects of the disease and its treatments. These may include:

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How Is Cancer In Lymph Nodes Found

Normal lymph nodes are tiny and can be hard to find, but when theres infection, inflammation, or cancer, the nodes can get larger. Those near the bodys surface often get big enough to feel with your fingers, and some can even be seen. But if there are only a few cancer cells in a lymph node, it may look and feel normal. Lymph nodes deep in the body cannot be felt or seen. So doctors may use scans or other imaging tests to look for enlarged nodes that are deep in the body. Often, enlarged lymph nodes near a cancer are assumed to contain cancer.

The only way to know whether there is cancer in a lymph node is to do a biopsy. Doctors may remove lymph nodes or take samples of one or more nodes using needles. The tissue thats removed is looked at under the microscope by a pathologist to find out if there are cancer cells in it. The pathologist prepares a report, which details what was found. If a node has cancer in it, the report describes what it looks like and how much was seen.

When a surgeon operates to remove a primary cancer, they may remove one or more of the nearby lymph nodes as well. Removal of one lymph node is considered a biopsy, but when many lymph nodes are removed, its called lymph node dissection. When cancer has spread to lymph nodes, theres a higher risk that the cancer might come back after surgery. This information helps the doctor decide whether more treatment, like chemo,immunotherapy, targeted therapy or radiation, might be needed after surgery.

Symptoms Point To Cancer’s Spread

Cancers Spread to Bone

Bone metastasis may not have any symptoms. But often, you’ll feel pain in your bones. The ache may come and go and first, often worsening at night and easing up when you’re active. Eventually it can become more intense and flare during activity.

If you have , you may have other symptoms as well, including:

Sometimes a fracture in your arms, legs, or spine is the first sign that your cancer has spread. You may break a bone when you fall, or incur what appears to be a trivial injury during your regular daily activities. The nature of the injury could be minor, and seem insufficient to fracture healthy bone. If occurs, you’ll feel sudden, severe pain. Get immediate treatmentespecially if the pain strikes in your back, a sign of a broken bone in your spine.

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What Happens When Metastatic Breast Cancer Spreads To The Bones

Bones are the most common place for metastatic breast cancer to spread. Several treatment options can slow the spread of metastases. There are also treatment options to reduce the associated pain and fatigue and prevent bone breakage.

Breast cancer is the second most common cancer among women in the United States. Nearly 30% of women who receive a diagnosis of early stage breast cancer develop MBC.

For over half of women with stage 4 breast cancer, the bones will be the first place it spreads to.

Cancer can spread to any bone in the body, but the most common places for this to occur are the long bones in the arms and legs, ribs, spine, and pelvis.

There is currently no cure for MBC, but people can continue to live full lives during treatment. There are a range of treatments for the MBC itself and for its symptoms.

Recent advances have substantially improved outcomes. There are more therapies currently undergoing trials.

This article looks at what happens when MBC spreads to the bones.

Dilemmas Of Stage Iv Breast Cancer

Indeed, there are many serious and personal questions involving stage IV breast cancer. So, overall survival is less likely, and gains from intensive breast cancer treatment are unfortunately rather modest. A serious consideration is, therefore, quality of life during the course of treatment.

These decisions tend to be a dynamic process, based on individual cases, between patients and physicians. Respect needs to be given to the expectations for treatment, the status of the disease and the patient wishes.

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What Is A Metastasis

Metastasis is a word that describes the spread of cancer from its original site to another part of the body. Metastasis happens when cells break away from the original cancer site and travel to other areas of the body through the bloodstream or the lymph system. Cancer cells then settle in different tissues or organs, where they grow and form a new tumour . When breast cancer is found in parts of the body other than the breast it is called metastatic breast cancer.

A bone metastasis from breast cancer is made up of breast cancer cells. Bone is one of the most common places for breast cancer to spread.

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