How Breast Cancer Spreads
Breast cancer can spread through the lymphatic system, the bloodstream, or by local invasionfor instance, when cancer cells actually invade nearby tissues, such as the chest wall or ribs.
When breast cancers spread and enter the lymphatic system, they usually first arrive at nearby lymph nodes and may still be early-stage.
Metastatic breast cancer is the same thing as stage 4 breast cancer and is considered the most advanced stage. It refers to breast cancers that have spread beyond the breast and nearby lymph nodes to other regions of the body, which are called distant metastases.
While treatment options for metastatic breast cancer are similar no matter where cancer has spread, some treatments are used for specific sites of metastasis as well .
Symptoms Of Metastasis May Vary Depending On Where The Cancer Has Spread To
Here are some symptoms that vary by locations commonly associated with breast cancer metastasis.
Metastasis in the bone may cause:
- Severe, progressive pain
- Bones that are more easily fractured or broken
Metastasis to the brain may cause:
- Persistent, progressively worsening headache or pressure to the head
- Vision disturbances
- Behavioral changes or personality changes
Metastasis to the liver may cause:
- Jaundice
- Abnormally high enzymes in the liver
- Abdominal pain, appetite loss, nausea, and vomiting
Metastasis to the lungs may cause:
- Chronic cough or inability to get a full breath
- Abnormal chest X-ray
- Chest pain
- Other nonspecific systemic symptoms of metastatic breast cancer can include fatigue, weight loss, and poor appetite, but its important to remember these can also be caused by medication or depression.
If you notice these symptoms, be sure you talk with your physician. They could be important for getting the treatment you need.
Interested in learning more? i3Health is hosting an upcoming webinar Metastatic Triple-Negative Breast Cancer: Applying Treatment Advances to Personalized Care. Learn more here.
How Is Metastasis In The Lungs Diagnosed
If you have symptoms or are at high risk for lung metastasis, your doctor might start with a physical examination and blood tests and decide on the next step from there. Common tests to diagnose metastasis in the lungs include a chest X-ray, a CT scan, or a PET scan. Your doctor might also choose to test a mucus sample or perform a bronchoscopy or needle biopsy of the lung.
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Treatment Options For Metastatic Breast Cancer In The Lungs
Although metastatic breast cancer is not curable, chemotherapy can weaken the cancer and stop it growing.
Doctors consider metastatic breast cancer to be a stage 4 cancer. It is not curable, and treatments focus on weakening the cancer to stop it from growing while working to improve the quality of life for the individual.
Treatments for metastatic breast cancer in the lungs usually involve systemic, or body-wide, medications that treat cancer throughout the body, such as the following:
Chemotherapy.Chemotherapy is a drug therapy that destroys all fast-growing cells in the body, both cancerous and healthy.
Hormonal therapy. Hormonal therapy is a cancer treatment that controls cancer cell growth by lowering the levels of certain hormones the cancer needs to grow. Hormone receptor-positive breast cancers respond well to this treatment.
Targeted therapy. This form of cancer treatment attempts to treat cancer with more precision than chemotherapy. These treatments target specific receptors, proteins, or molecules on cancer cells that either make it easier for the bodys immune system to identify and destroy cancerous cells or reduce their growth.
Radiation. In the case of metastatic breast cancer, doctors often use radiation therapy to reduce symptoms and control the cancers growth. Radiation therapy can help reduce pain and lower the risk of broken bones weakened due to cancer.
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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How To Reduce The Risk Of Metastasis
After someone has received initial treatment, breast cancer can lay dormant in the body before spreading to other areas. People who have received treatment in the past should monitor themselves for any signs or symptoms that could indicate cancer recurrence.
While there is no single way to avoid developing metastatic breast cancer entirely, there are some lifestyle changes that can help reduce a persons risk.
People may reduce the risk of metastases with the following factors:
- having regular health screenings
What Treatments Are Available For Metastatic Breast Cancer In The Lungs
Metastatic breast cancer that has migrated to the lungs is stage IV cancer and is considered incurable. However, many patients can still have several years of high-quality life with proper treatment to slow the growth and spread of cancer cells. Some options include chemotherapy, hormonal therapy, targeted therapy, and radiation. Your doctor may suggest one of these treatments or a combination.
Your treatment plan will likely depend on several factors, such as how extensive the cancer is within the lung, whether the cancer has spread to other organs, what symptoms you have, what treatments youve already had, whether youve been through menopause, and your general health. You can help yourself stay healthy for cancer treatment by eating well, getting enough sleep, and exercising as much as possible.
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Can Lung Cancer Spread To The Breasts
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Poor Appetite And Weight Loss
Sometimes people with secondary breast cancer cant eat as much as usual. This means they have difficulty maintaining their weight as well as providing the body with energy. Low energy levels can affect mobility and might make it harder to manage any symptoms such as breathlessness.
Poor appetite can be due to the effects of the cancer, treatment or anxiety. A small number of people may have difficulty swallowing.
You might find it easier to eat little and often instead of having set meals. If you still feel you arent eating enough, are losing weight or have no interest in food, talk to your doctor or specialist nurse about dietary supplements or ask to speak to a dietitian for specialist advice.
In some circumstances you may be prescribed medication to help stimulate your appetite.
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Types Of Breast Cancer
There are several types of breast cancer, and any of them can metastasize. Most breast cancers start in the ducts or lobules and are called ductal carcinomas or lobular carcinomas:
- Ductal carcinoma. These cancers start in the cells lining the milk ducts and make up the majority of breast cancers.
- Lobular carcinoma. This is cancer that starts in the lobules, which are the small, tube-like structures that contain milk glands.
Less common types of breast cancer include:
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Medullary
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Metaplastic
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Papillary
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Inflammatory breast cancer is a faster-growing type of cancer that accounts for about 1% to 5% of all breast cancers.
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Pagets disease is a type of cancer that begins in the ducts of the nipple.
Breast cancer can develop in women and men. However, breast cancer in men is rare. Less than 1% of all breast cancers develop in men.
Nsg Mice Are Highly Susceptible To Metastasis Formation
In order to develop a system that models the entire metastatic process, we injected aggressive basal MDA-MB-231 human breast carcinoma cells orthotopically into the mammary fat pads of nine severely immunocompromised NSG mice. Mice were monitored for development of primary xenograft tumors and sacrificed when tumors reached 10% of body weight. Following injection, the primary mammary fat pad tumors grew rapidly , resulting in sacrifice of the mice at day 53 post-injection. Harvested primary mammary fat pad tumor tissue was immunohistochemically stained for CK18, EGFR and Her2 expression. MDA-MB-231 primary tumors were CK18 positive, EGFR positive, Her2 negative , demonstrating that the xenograft tumors retained the MDA-MB-231 cell line expression pattern of key breast cancer markers. At necropsy mice were examined visually for macro-metastases. Macro-metastases were frequently and consistently observed in axillary lymph nodes , lungs , liver , and diaphragm , as well as sporadically in other organs . Organs were harvested and the presence of metastases was confirmed by H& E and CK18 staining of tissue sections .
NSG mice consistently develop widespread macro-metastases when MDA-MB-231 cells are injected orthotopically into the mammary fat pad.NSG mice consistently develop macro-metastases when MDA-MB-436 cells are injected orthotopically into the mammary fat pad.Transcriptional changes in MDA-MB-231 and MDA-MB-436 macro-metastases relative to primary tumors.
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New Evidence Suggests Early Metastasis Is Common In Lung And Breast Cancers
It’s not news any cancer patient really wants to hear. Cancer geneticist Christina Curtis, PhD, and postdoctoral researcher Zheng Hu, PhD, have found that in breast and lung cancer patients with metastatic disease, the seeds of metastasis were often planted well before the primary tumor was diagnosed.
What’s more, treatments given to prevent recurrence after the primary tumor is removed — a category of therapy called adjuvant treatments that includes chemotherapy, hormone and targeted drug therapies — can end up promoting the growth of drug-resistant cells in the distant metastases.
Curtis and Hu published their results recently in Nature Genetics. The findings dovetail with their previous discovery that most colorectal cancers have metastasized before diagnosis. But although it may sound grim, the researchers emphasize that it’s important to understand how cancers evolve in the body in order to develop new treatments to better combat recurrence.
As Curtis explained:
Metastatic tumors have been under-characterized, in part because it has been difficult to get matched samples of primary and metastatic tumors from patients. Ours is the largest study to date, and addresses a long-standing question in the field as to how metastasis happens. Our findings indicate that, quite frequently in lung and breast cancers, metastasis occurs two to four years before the primary tumor has been detected.
Survival Rates For Metastatic Breast Cancer
According to the American Cancer Society , the 5-year survival rate after diagnosis for people with stage 4 breast cancer is 28 percent. This percentage is considerably lower than earlier stages. For all stages, the overall 5-year survival rate is 90 percent.
Because survival rates are higher in the early stages of breast cancer, early diagnosis and treatment is crucial. But remember: The right treatment for stage 4 breast cancer can improve quality of life and longevity.
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Prognosis Of Breast Cancer That Has Spread To The Lungs
Making a breast cancer prognosis isnt always a simple cut-and-dried process. This is also true for breast cancer that has spread to the lungs. Several factors can affect the prognosis, according to the American Cancer Society. Those factors can include age, health, and tumor characteristics .
Breast Cancer
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Almost one out of every eight women is likely to get breast cancer during her lifetime, according to the American Cancer Institute, and one out of every 35 is likely to die from it . In addition, in the United States, breast cancer is the second-most common cancer . But breast cancer can spread into other parts of the body, affecting the prognosis.
Prognosis and Breast Cancer
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To provide a breast cancer patient with the most accurate prognosis for recovery and the best treatment options a doctor must evaluate how far the cancer has spread within the breast as well as the rest of the body. In fact, according to the American Cancer Society, knowing the breast cancer stage will be a major factor in prognosis determination.
Sometimes the breast cancer stage is arrived at through a biopsy, a physical exam or a test . Other times it is arrived at through testing results coupled with actual surgery .
Prognosis and the Cancer Stage Classification
Prognosis Factors and Validity
Prognosis
What Is Metastatic Breast Cancer In The Lungs
Doctors refer to metastatic breast cancer as stage 4 breast cancer.
Metastatic is a term that refers to cancer that has spread outside of the original area to a different place in the body. Metastatic breast cancer in the lungs refers to cancer that originally developed inside the breast tissue but has spread to the lungs.
Breast cancer is the most common form of cancer among women. Around 610 percent of initial breast cancers that a doctor diagnoses are metastatic. This number does not include breast cancers that progress to stage 4 after the initial diagnosis. Typically, oncologists call metastatic breast cancer stage 4 breast cancer.
Some of these metastatic breast cancer cells may affect the lungs. It is essential that an oncologist confirms that the tumor in the lungs is secondary, meaning that it contains breast cancer cells. If there are no breast cancer cells present, the tumor could be a newly developed primary cancer.
People may not experience symptoms of metastatic breast cancer in the lungs immediately. If symptoms do appear, they can resemble those of a cold or flu.
Symptoms of metastatic breast cancer in the lungs include:
- a constant cough
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Emotional And Spiritual Care
End-of-life care also includes emotional, mental, and spiritual therapy. A personâs healthcare team may include social workers, counselors, mental health professionals, and religious or spiritual advisors.
According to the Anxiety and Depression Association of America, up to 40 percent of people with cancer experience serious mental distress. This may include anxiety, depression, panic attacks, and post-traumatic stress disorder .
Medications, therapy, religious or spiritual rituals, and support groups can help a person cope with mental health issues and stress during this difficult time.
Caregivers may also need help with stress, anxiety, and depression. The palliative care team can usually also provide support and advice to caregivers for their emotional needs.
The Breast Cancer Healthline app provides people with access to an online breast cancer community, where users can connect with others and gain advice and support through group discussions.
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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What Is The Prognosis Of Metastatic Breast Cancer In The Lungs
Metastatic cancer is the most advanced form of cancer and is not considered curable. However, some people survive for many years with their disease and live a happy and healthy life despite their disease.
The average five-year survival rate for metastatic breast cancer in the lungs is about 22 percent. Your ability to survive and thrive for several more years depends on a variety of factors, such as your age, your overall health, the size of your tumors, how the tumors respond to treatment, and whether the cancer has metastasized to just the lungs or to other areas of the body as well.
How Are Lung Metastases Diagnosed
You may be diagnosed with lung metastases after you report symptoms to your doctor and your doctor orders a test. Or, you may be diagnosed with lung metastases after a routine test suggests something is wrong.
Doctors use tests to create pictures of the lungs and learn whether cancer has spread to them. CT scans or a combination of a and a PET scan called PET-CT are the imaging tests most often used to diagnose lung metastases. Doctors may also use chest x-rays, or, less often, MRIs.
Sometimes these tests arent enough to confirm a of lung metastases. In that case, your doctor may recommend a bronchoscopy, in which a doctor inserts a thin, lighted tube into your nose or mouth to look at your airways. This allows your doctor to look for tumors in your lungs.
Your doctor may also recommend a . During a lung biopsy a removes a small piece of suspicious-looking lung so it can be tested for breast cancer cells. More and more, doctors are using CT scans to guide the bronchoscopy or biopsy, which makes the process less invasive.
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