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What Is Stage Four Breast Cancer

Stage 4 Breast Cancer Survivor Stories

Stage 4 Breast Cancer Definition

Following are stories from two survivors of breast cancer, told in their own narrative.

“I am Kathy from Littleton, Colorado. I had been a successful hairstylist till the March of 2013. I was used to the occasional back ache as I did most of my work standing up, but one day the backache was so bad I had to go to the hospital to get some relief. After getting an MRI, I received the news that I had stage four breast cancer that had metastasized in my bones. My stage 4 breast cancer life expectancy was only two months. When looking for treatment, I found the University of Colorado Anchutz Cancer Center. For a year I went through chemotherapy once a week, three biopsies and three rounds of radiation. After two years, I am still battling my cancer while living a healthy life. My doctors call this a miracle as I go to the gym five days a week, work for various cancer awareness organizations and recently started a new business.”

Treatment For Metastatic Breast Cancer

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.

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.

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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.

Types Of Bone Metastases

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Normally your bones are constantly changing. New bone tissue is being formed and old bone tissue is breaking down into minerals that circulate in your blood. This process is called remodeling.

Cancer cells upset the normal process of bone remodeling, causing bones to become weak or too dense, depending on the type of bone cells affected.

Your bone metastases may be:

  • osteoblastic, if there are too many new bone cells
  • osteolytic, if too much bone is destroyed

In some cases, your bones may have both types of metastases.

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De Novo Metastatic Breast Cancer And Recurrent Breast Cancer

It is important to understand the two types of Stage IV Breast Cancer and the differences between them:-

  • De Novo metastatic breast cancer: This term refers to women who are Stage IV at the initial diagnosis of breast cancer. That is, cancer has already spread to other parts of the body. De novo metastatic breast cancer accounts for only around 6% of cases at diagnosis in the US.
  • Recurrent Breast Cancer: More often, breast cancer returns or spreads after the initial diagnosis and treatment of breast cancer. This recurrence can happen months, or even years, after the first presentation and treatment.
  • 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.

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    Its Never Too Late To Exercise

    Exercise is important for your overall mental and physical health. Since fatigue is often a symptom associated with stage 4 breast cancer, it can help to plan your exercise during your most energetic time of day.

    Consistency is key. Its better to exercise in small amounts every day than to follow an extreme pattern of occasional intense activity between long periods of inactivity.

    While there are potential benefits to exercise when you have stage 4 cancer, its important to talk to your healthcare provider before starting an exercise program.

    If your blood counts are low or your electrolyte levels are imbalanced, most healthcare providers wont recommend exercising because you could put yourself at risk for further harm.

    Also, your healthcare provider may recommend avoiding public places, like gyms, because of your risk for germ exposure.

    Safety is always a concern when you have stage 4 breast cancer. Bleeding and risks of injury are important considerations.

    Some women experience balance and foot numbness problems due to their treatments and fatigue. If this is the case, its best to do exercises that put you at less risk for falls. An example could be riding a stationary bicycle instead of running on a treadmill.

    There might not be a direct link between exercise and stage 4 breast cancer survival rates, but you can reap other benefits from regular exercise.

    For example, it may help you:

    • lose excess body fat
    • improve your quality of life
    • reduce side effects from treatment

    Treatment For Stage 4 Breast Cancer

    What Are the Treatment Options for Stage 4 Breast Cancer?

    Breast cancer treatment will differ depending on the type of breast cancer, where it has been discovered, the size of tumors and even the number of tumors.

    The medical team will look at past treatments the patient has had, symptoms they might be suffering from and their general health to determine the new type of treatment.

    While stage 4 breast cancer is no longer curable it is treatable and manageable which is the aim of the various treatments. A treatment plan will be put in place to control and slow down the spread of the cancer, relieve symptoms and maintain health and well-being to give the best quality of life.

    Treatment could be given in a combination of ways, and if one doesnt or stops working, then there are others that can be looked at.


    It might be possible to operate and remove the new tumors or reduce them in size.


    Radiotherapy can be given to help reduce the pain and other symptoms when the cancer has spread to the bones or brain as it can be targeted to the area that the cancer has spread to.


    Type of chemotherapy, frequency, and dosage can all vary depending on the type of breast cancer. Intravenous chemotherapy can be given the same as with primary breast cancer.

    Some people may require chemotherapy for life which is likely to be in a tablet form and not have as harsh side effects as intravenous chemotherapies.

    Hormone Therapy

    Drugs have been developed to reduce the amount of hormones in the body.

    Targeted Therapy

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    Wait What Men Get Breast Cancer Too

    It came as a heavy jolt when Michael Kovarikwas first diagnosed in 2007.

    “I remember just like, sitting down and going, wait a minute, wait a minute. Women get breast cancer. Men don’t get breast cancer. So, it was very much a shock,” he told me when we first spoke. “There were people that didn’t quite believe it at first. And so, it was a way of educating people a lot at the beginning. But I think that made it more real to me.”

    He had a recurrence in 2010 and was diagnosed with metastatic disease in 2015.

    “The fatigue is unreal,” Kovarik said. “I’m struggling right now, but hopefully things will get better.”

    He became active in the Male Breast Cancer Coalition and MBC Alliance and, like Jamil Rivers, in Metavivor. Metastatic disease is the primary lethal form of breast cancer, yet only 7% of breast cancer research is devoted to curing it.

    “We get answers to stopping this disease,” Kovarik said when we last spoke in August.Michael Kovarik died from MBC on Sept. 22, 2021.He is survived by his long-time partner, Tim Watkins.

    What Doesn’t Affect Survival

    Just as there are factors associated with a better or worse prognosis, there are some factors that do not appear to make a big difference. These are generally less understood by the general public:

    • Aggressiveness of treatment
    • Having a positive attitude

    The goal of treatment for metastatic breast cancer is often very different than that of early-stage disease, and this can raise anxiety among patients and loved ones of patients. With early-stage breast cancer, the goal is usually to be aggressive in order to reduce the risk that the cancer will come back.

    In contrast, with stage 4 disease, the goal is usually to use the minimum amount of treatment possible to control the disease . Studies have found that more aggressive treatment does not improve survival rates but does reduce quality of life.

    While having a good attitude may improve your sense of well-being, it has not been shown to affect survival rates. In fact, holding in negative emotions in order to appear positive may be detrimental to your health in general.

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    Treatment Options For Stage 4 Cancer

    Stage 4 cancer is challenging to treat, but treatment options may help control the cancer and improve pain, other symptoms and quality of life. Systemic drug treatments, such as targeted therapy or chemotherapy, are common for stage 4 cancers.

    Often, a clinical trial may be an option, offering new treatments to help you fight stage 4 cancer.

    Below are the prevailing treatment options for the five most common cancers.

    Treatment of stage 4 breast cancer: For cancer that has spread beyond the breast and nearby lymph nodes, systemic drug treatments are typically used. These include:

    • Hormone therapy
    • Chemotherapy
    • Immunotherapy

    They may be used alone or in combination, and they may also be determined by the hormone receptor and the HER2 status of the cancer.

    Surgery and radiation may be treatment options in specific cases to help improve symptoms caused by a growing tumor, not to get rid of the cancer. The tumor may be removed with surgery or shrunk by radiation therapy if, for example, its:

    • Blocking a blood vessel
    • Causing a wound
    • Affecting the spinal cord

    Treatment of stage 4 lung cancer: In general, stage 4 lung cancer is also treated with systemic drug therapies.

    Stage 4 lung cancer that has spread to one distant area tends to be treated differently than lung cancer that has spread more widely. For stage 4A cancers, treatment tends to focus on the one site where the cancer has spread.

    There may also be clinical trials assessing new treatments for stage 4 melanoma.

    What Is Stage 2 Breast Cancer

    Please Help Me Survive Stage 4 Breast Cancer

    Also known as invasive breast cancer, the tumor in this stage measures between 2 cm to 5 cm, or the cancer has spread to the lymph nodes under the arm on the same side as the breast cancer. Stage 2 breast cancer indicates a slightly more advanced form of the disease. At this stage, the cancer cells have spread beyond the original location and into the surrounding breast tissue, and the tumor is larger than in stage 1 disease. However, stage 2 means the cancer has not spread to a distant part of the body.

    At stage 2, a tumor may be detected during a breast self-exam as a hard lump within the breast. Breast self-exams and routine screening are always important and can often lead to early diagnosis, when the cancer is most treatable.

    Stage 2 breast cancer is divided into two categories:

    Stage 2A: One of the following is true:

    • There is no tumor within the breast, but cancer has spread to the axillary lymph nodes, or
    • The tumor in the breast is 2 cm or smaller and cancer has spread to the axillary lymph nodes, or
    • The tumor in the breast measures 2 cm to 5 cm but cancer has not spread to the axillary lymph nodes.

    Stage 2B: One of the following is true:

    • The tumor measures 2 cm to 5 cm and cancer has spread to the axillary lymph nodes, or
    • The tumor is larger than 5 cm but cancer has not spread to the axillary lymph nodes.

    At stage 2, TNM designations help describe the extent of the disease. Most commonly, stage 2 breast cancer is described as:

    Stage 2 breast cancer survival rate

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    Relative Survival Rates For Breast Cancer

    The National Cancer Institute gives 5-year relative survival rates for breast cancer based on how far the disease had spread before a doctor found it.

    • Localized : 99%
    • Unknown stage: 55%
    • All stages: 90%

    While these numbers can give you a general idea, they are an average for women with any type of breast cancer. They arent specific to the HER2+ type. They also come from data that researchers collected from 2010 to 2016, so they dont reflect more recent treatment advances.

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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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    Coping With Advanced Breast Cancer

    Being told that you have advanced or metastatic breast cancer may be very confronting or overwhelming. Some women also find the news that their cancer has spread or come back is more devastating than their original diagnosis.

    There are many resources available online to help you further understand the meaning of your diagnosis and how to manage the emotional, physical and practical issues arising from metastatic breast cancer. Below are some links where these resources can be accessed:

    Connecting and speaking with others who have gone through a similar experience can also be helpful. Cancer Council runs support groups all across Australia which can provide support and information for people with cancer and their families. Groups in each state can be accessed here:

    Although support groups can provide a safe place for people to express their feelings amongst others who share a similar experience, some people are more comfortable talking one-on-one, such as with a counsellor, therapist or trained volunteer . Your GP can also refer you to a psychologist, social worker or other trained therapist. Every person is different and it is important to find a healthy support system that works for you.

    Talking To Other People

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    Talking about how youre feeling can often help you cope in the early days. You may be able to do this with family and friends, but many people find this very difficult.

    Talking with a specialist nurse can often help. You can ask to be put in contact with one if you havent already.

    Breast Cancer Now is also here to help. Through our services you can:

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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.

    Tips For Coping With Stage 4 Breast Cancer

    If you have recently been diagnosed with stage 4 breast cancer, it can be difficult to swallow and cope with the news. Below, I have some tips that may help you cope with this stage of breast cancer:

    Join an Online Community

    Joining an online community with other people who have stage 4 cancer can be supportive. It is a place where you can ask questions to people who were going through similar treatments and even having similar thoughts and worries. These people do not know you personally so you can be as open as you want.

    Be Careful What You Read on the Internet

    Only research from reputable sources. There is so much information on the internet, and most of it does not all happen to be true. Use websites that have done their research, even though a lot of sources on the internet can be helpful if the information you are reading is untrue it could cause distress.

    Remember Everyone Is Different

    Even though in essence it is the same disease, it has different variants which will lead to different treatment, different side effects, and different outcomes.

    Speak to Family and Friends

    Speaking about your breast cancer diagnosis and treatment may help, dont feel as though you have to bottle everything up. But you dont have to tell them everything, and you will know how much you want people to know so dont feel under pressure to disclose things you dont want to.

    Seek Professional Help

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