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When Metastatic Breast Cancer Progresses

Treatment For Physical Symptoms

Biomarkers for Treatment and Progression | 2021-2022 EMBRACE MBC Virtual Forum Series

The American Cancer Society urge that a person should not have to endure pain in the final months and days of life.

Many people find relief with opioid medications, but these can cause side effects such as fatigue and constipation. A person may use opioids in combination with other pain relief medications, such as acetaminophen or ibuprofen.

Other drugs, such as antidepressants and antiseizure medications, can also treat certain types of pain.

Doctors can also prescribe medications for nausea and vomiting. Some drugs for treating nausea can make a person drowsy. However, these drugs may help people eat and drink more or simply make it easier for them to function and interact with other people.

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.

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.

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Chemotherapy For Breast Cancer Progresses To Liver Metastases After Surgery And Systemic Treatment

Tao Yin1#, Lei Nie1#, Dongde Wu1, Baozhen Liu2, Yaojun Feng3, Xinhong Wu3, Chenggang Luo1, Jianjun Liang4

1 Department of Hepatobiliary and Pancreatic Surgery , Hubei Cancer Hospital of Hua Zhong University of Science & Technology , School Hospital of Wuhan Textile University , Department of Breast Cancer Surgery , Hubei Cancer Hospital of Hua Zhong University of Science & Technology , First Hospital of Wuxue County , , China

Contributions: Conception and design: T Yin, L Nie, D Wu Administrative support: B Liu, Y Feng Provision of study materials or patients: X Wu, C Luo Collection and assembly of data: B Liu, Y Feng, J Liang Data analysis and interpretation: T Yin, L Nie, D Wu Manuscript writing: All authors Final approval of manuscript: All authors.

#These authors contributed equally to this work.

Correspondence to:

Background: This study aims to evaluate the effectiveness of hepatic arterial infusion chemotherapy/portal vein infusion chemotherapy , transcatheter hepatic arterial chemoembolization and transcatheter arterial embolization for unresectable breast cancer liver metastases .

HAIC/PVIC with the same regional chemotherapy regimen of the original systemic treatment is feasible, and can benefit patients with UBCLM, who have progressed on prior systemic therapies.

Keywords: Unresectable breast cancer liver metastases hepatic arterial infusion chemotherapy/portal vein infusion chemotherapy prognosis

doi: 10.21037/tcr.2019.12.59

About Those Lymph Nodes

Breast cancer progression  The above figure provides a ...

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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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.

What Is Metastatic Breast Cancer

Metastasis is the process by which cancer cells spread. In the case of metastatic breast cancer, the cancer originated in breast tissue, then spread to other parts of the body.

Metastatic cancer is further described as local, regional or distant, depending on the location of the cancer cells in relation to the original tumor.

  • Localized metastatic breast cancer often means the breast cancer has spread to nearby lymph nodes.
  • The more distant locations include the bones, lungs, skin, liver and brain, although its possible for other parts of the body to be affected.

Its important to remember that every cancer is unique and that your experience may not necessarily be the same as that of another breast cancer patient. With a personalized treatment plan, metastatic breast cancer is typically treatable. A recent National Cancer Institute study found that the number of U.S. women living longer with distant metastatic breast cancer is growing, thanks to advances in treatments.

Its also important to prepare yourself with information about the disease, its symptoms and how its detected and treated.

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Treatment For Liver Metastasis

Metastatic breast cancer in any part of the body is usually treated with systemic medications, which treat cancer throughout the entire body. For liver metastasis, local treatments that specifically target the liver, such as surgery or radiation, are sometimes recommended.

Chemotherapy destroys or damages cancer cells as much as possible and, therefore, doctors recommend it as a treatment for metastatic breast cancer. Because chemotherapy medicines are systemic treatments meaning they affect the entire body doctors generally recommend chemotherapy if:

  • the cancer is growing quickly

Doctors often combine chemotherapy with targeted therapies, which are medicines that target specific characteristics of cancer cells.

Each persons chemotherapy treatment plan is different. But there are some general guidelines that doctors follow when using chemotherapy to treat metastatic breast cancer:

If breast cancer comes back after chemotherapy or doesnt respond to chemotherapy medicines, you can try a different combination of medicines. There are many chemotherapy medicines, and if one medicine or combination of medicines doesnt work, there is almost always something else you can try.

Localized chemotherapy directs chemotherapy medication into liver tumors, avoiding damage to surrounding healthy organs.

There are a couple of local chemotherapy options for liver metastasis:

Learn more about Hormonal Therapy.

Learn more about targeted therapies used to treat metastatic breast cancer.

Stage Ii Breast Cancer

Choosing to Enjoy Life Despite Metastatic 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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Diagnosing Metastatic Breast Cancer

Getting a clear picture of where breast cancer has spread is essential for creating a personalized treatment plan. Your care team will likely use a combination of the following tests and tools to diagnose both localized and advanced breast cancer:

Ultrasound exam: With this imaging technique, sound waves create a picture of internal areas of the body.

Magnetic resonance imaging : This procedure produces detailed images using magnetic fields and radio waves.

Blood chemistry studies: A blood sample is taken to measure the amounts of certain substances that are released by your organs and tissues. A higher or lower amount of a particular substance may be a sign of disease.

Breast biopsy: A biopsy is the removal of cells or tissues so a pathologist may view them through a microscope. Your original breast cancer diagnosis was likely confirmed with a biopsy.

Myc Inhibition Halts Metastatic Breast Cancer Progression By Blocking Tumor Growth Invasion & Seeding

  • VHIO-led research published in Cancer Research Communications shows that the first-in-class MYC inhibitor Omomyc effectively halts disease progression in metastatic breast cancer, from seeding to cancer cell spread, in vitro and in vivo.
  • For the first time, the investigators show that MYC inhibition by Omomyc dramatically reduces both primary and metastatic growth in breast cancer.
  • The validation of the Omomyc mini-protein for the treatment of metastatic disease could ring in a new therapeutic opportunity for patients suffering from triple-negative breast cancer.

Barcelona, February 21, 2022. Published inCancer Research Communications , a journal of the American Association for Cancer Research , findings reported by investigators of the Vall dHebron Institute of Oncologys Models of Cancer Therapies Group , and VHIO-born spin-off Peptomyc S.L., show that MYC inhibition is anti-metastatic in breast cancer.

The deregulation of the pleiotropic and ubiquitous MYC oncoprotein is implicated in almost all human cancers, and while its role as a promoter of tumorigenesis is beyond doubt, its function in the process of metastasis remains controversial. Contrasting reports suggest both a pro-metastatic and anti-metastatic function of MYC have largely precluded research assessing MYC inhibitors in the metastatic setting.

Also Check: What Organs Are Affected By Breast Cancer

Support For Living With Secondary Breast Cancer In The Liver

Everyones experience of being diagnosed with secondary breast cancer is different, and people cope in their own way.

For many people, uncertainty can be the hardest part of living with secondary breast cancer.

You may find it helpful to talk to someone else whos had a diagnosis of secondary breast cancer.

  • Chat to other people living with secondary breast cancer on our online Forum.
  • Meet other women with a secondary diagnosis and get information and support at a Living with Secondary Breast Cancer meet-up.
  • Live Chat is a weekly private chat room where you can talk about whatevers on your mind.

You can also call Breast Cancer Nows Helpline free on 0808 800 6000.

Metastasis Is A Highly Inefficient Yet Lethal Process

Oncology

In the next few sections, we introduce the concept of tumour dormancy and discuss its ties with DTC dissemination in order to highlight how its reversible nature might alter the equilibrium between unsuccessful and successful metastases, thus possibly dictating the timing of metastatic relapse, or whether relapse occurs at all. We then focus on two key determinants of relapse in HR+ breast cancer: the extrinsic effect of targeted therapy, and the consequences of intrinsic HR function modulation.

Also Check: Breast Cancer Characteristics

Can Metastatic Breast Cancer Go Into Remission

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.

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.
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    Ringing In Myc Inhibition In The Metastatic Setting

    Metastases are genetically unstable. Information from a patients primary tumor might not mirror the metastasis, and one metastasis may vary from another, thus hampering the benefits of targeted therapies. Based on their data indicating the efficacy of MYC inhibition independently of the mutational profile of the tumor, the investigators hypothesized that this approach could overcome th challenge.

    They also sought to establish if MYC inhibition could revert MYCs promotion of epithelial-mesenchymal transition and dedifferentiation, two important hallmarks of cancer metastasis.

    Can Metastatic Breast Cancer Be Cured

    What is progression free survival (PFS) as it relates to metastatic breast cancer therapy?

    There is no cure for metastatic breast cancer. Once the cancer cells have spread to another distant area of the body, its impossible to get rid of them all. However, the right treatment plan can help extend your life and improve its quality.

    Metastatic breast cancer treatment aims to shrink tumors, slow their growth and improve your symptoms.

    Also Check: Stage 4 Breast Cancer Cure

    Treatment Of Stage Iv Breast Cancer

    Stage IV cancers have spread beyond the breast and nearby lymph nodes to other parts of the body. When breast cancer spreads, it most commonly goes to the bones, liver, and lungs. It may also spread to the brain or other organs.

    For women with stage IV breast cancer, systemic drug therapies are the main treatments. These may include:

    • Some combination of these

    Surgery and/or radiation therapy may be useful in certain situations .

    Treatment can often shrink tumors , improve symptoms, and help some women live longer. These cancers are considered incurable.

    What Is The Treatment For Metastatic Breast Cancer

    Treatments include many of the same treatments as other stages of breast cancer:

    • Chemotherapy
    • Radiation therapy
    • Hormone therapy For patients diagnosed with Stage IV breast cancer that is hormone receptor positive, hormonal therapy may be the first line of defense against the disease. As long as the drugs are keeping the cancer from progressing, the patient may be kept on the medication for some time. If scans show the progression of the cancer, the medical oncologist may switch to another form of hormonal therapy or possibly stop this therapy and pursue a different line of systemic treatment, such as chemotherapy or biologic targeted therapy.
    • Biologic targeted therapy
    • Breast surgery It is controversial whether surgery should be done on the breast in the presence of known metastatic disease. In most cases, however, the knowledge of metastasis is discovered after the breast cancer surgery and other treatment has been performed. The cancer returns as a distant recurrence.

    Recommended Reading: Recurring Breast Cancer Symptoms

    The Role Of Caregivers

    Caregivers also play a vital role in helping a person with cancer be as comfortable as possible. To help, a caregiver can:

    According to the American Society for Clinical Oncology, in 2018, doctors will diagnose invasive breast cancer in an estimated 268,670 people in the United States.

    The ACS state that the 5-year relative survival rate for people with metastatic breast cancer is around 22 percent. This means that people with metastatic breast cancer are 22 percent as likely as people without the condition to live at least 5 years following diagnosis.

    However, many factors can affect how long a person with metastatic breast cancer lives for, including:

    • the type of breast cancer
    • the stage of breast cancer
    • where the cancer has spread to
    • how well the cancer responds to treatment
    • any other health issues that the person has

    Everyoneâs outlook is different. It is also important to note that survivals rates are just estimates, and that doctors base these figures on data from at least 5 years ago. Continuing advancements in cancer treatments means that survival rates are improving.

    Phase : Living With Progressive Disease

    Disease progression model of breast cancer metastasis ...

    Uncertainty pervaded every element of women’s lives during this phase of illness. The continual oscillations between illness, treatment and recovery that women experienced undermined their ability to adjust. Those with more aggressive disease appeared to have little respite from the cycle of disease progression and treatment. They struggled to keep pace with changing events which eroded their sense of self and ability to adjust and adapt to the rapidity of events, at the same time as coping with the present and a foreshortened future.

    For example, Jill’s illness trajectory highlighted a life with metastatic breast cancer which was dominated by sequential treatments. Over a 3-year period, she endured nine different episodes of treatment . Jill went through cycles of feeling and looking well and living her life to the full, followed by disease progression and illness.

    A few of the women had involvement with palliative care services, but only one maintained this relationship over time.

    All the women had times when their disease was stable. During this time, anticipating progressive disease meant the women lived with relentless vigilance over their bodies.

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    Palliative And Supportive Care

    Palliative and supportive care focuses on symptom control and support. Its an extremely important part of the care and treatment for many people living with secondary breast cancer and can significantly improve quality of life for them and their families.

    People often associate palliative care with end-of-life treatment. However, many people value having it at any stage of their illness, alongside their medical treatment, to help prevent and relieve symptoms such as pain or fatigue. It can also help with the emotional, social and spiritual effects of secondary breast cancer.

    The palliative and support care teams are based in hospitals, hospices and the community. You can be referred by your treatment team, GP or breast care nurse depending on your situation.

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