Where Does Breast Cancer Spread To First
Like all forms of cancer, breast cancer can potentially spread beyond the breast tissue where it initially developed to other areas of the body. In order for breast cancer metastasis to occur, cancerous cells must break away from the original tumor and attach themselves to the outer wall of a lymph vessel or a blood vessel. Then, the cancer must penetrate the vessel wall so that it can flow with the blood or lymphatic fluid to reach a lymph node or organ.
What Happens After A Sentinel Node Biopsy
If the lymph nodes do not contain cancer cells, you wont need to have any more nodes taken out.
If cancer cells are in the sentinel nodes, you have another operation to remove most or all of the lymph nodes under your arm. This is an axillary lymph node dissection or clearance. You generally have it about 2 weeks after you get the results.
Some people have radiotherapy to the armpit to destroy any remaining cancer cells instead of surgery.
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How Does Cancer Spread Beyond The Breast
Breast cancer can invade through nearby tissue, or spread through the body via the lymphatic system and blood.
- Tissue: the cancer spreads from the original site and grows into nearby areas .
- Lymphatic system: breast cancer cells break away from the original site and can enter nearby lymph tubes , grow in nearby lymph nodes or travel through lymph vessels to other parts of the body.
- Blood: breast cancer cells break away from the original site and can enter and travel through nearby blood vessels to other parts of the body.
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If Cancer Has Spread To The Liver
Some women may have discomfort or pain in the liver, which is on the right side of the tummy under the ribs. Other symptoms may include feeling sick, losing your appetite, or feeling very tired and generally unwell.
Occasionally, secondary breast cancer in the liver results in a build-up of bile in the blood causing jaundice. This makes the skin and whites of the eyes become yellow and skin feels itchy.
The liver is a large organ and can still work well even when it is affected by cancer. When your treatment – usually chemotherapy – starts to work, the symptoms will improve.
If Your Breast Cancer Has Spread
Even if your breast cancer has spread to other parts of your body, it does not necessarily mean its not treatable. If the cancer cannot be removed, the goal of treatment is to improve symptoms, improve quality of life and extend survival.
Some women live with breast cancer for several years as they learn to adjust and accept that theyll be on treatment for an indefinite period of time, explains Dr. Roesch. Your cancer team will help you learn and cope with what you can expect on this journey.
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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
Treatment can often shrink tumors , improve symptoms, and help some women live longer. These cancers are considered incurable.
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.
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Where Does Breast Cancer Metastasize To
Sometimes, breast cancer spreads to other parts of the body. This does not always happen, but when it does, it is known as metastatic breast cancer.
Metastatic breast cancer is treated differently than localized breast cancer. As a result, oncologists typically check for evidence of metastasis during the diagnostic/staging process. Additionally, breast cancer can spread after a patient has been diagnosed. To watch for potential signs of metastasis, patients are typically scheduled for frequent imaging scans during and after treatment.
Can Stage 4 Breast Cancer Go Into Remission
Stage 4 breast cancer can go into remission, meaning that it isnt detected in imaging or other tests. Pathological complete remission indicates a lack of cancer cells in tissues removed after surgery or biopsy.
But its rare to take tissue samples while treating stage 4 breast cancer. This could mean that although treatment has been effective, it hasnt completely destroyed the cancer.
Advances in stage 4 breast cancer treatments are helping to increase the length of remission.
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Lymphangiogenesis And Lymphatic Metastasis
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 .
Support For Living With Secondary Breast Cancer
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 whatever is on your mind.
You can also call Breast Cancer Nows Helpline free on 0808 800 6000.
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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:
Inflammatory breast cancer is a faster-growing type of cancer that accounts for about 1% to 5% of all breast cancers.
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.
When Can Metastatic Breast Cancer Occur
Some people have metastatic breast cancer when they are first diagnosed with breast cancer . This is called de novo metastatic breast cancer.
Most often, metastatic breast cancer arises years after a person has completed treatment for early or locally advanced breast cancer. This may be called a distant recurrence.
A diagnosis of metastatic breast cancer is not your fault. You did nothing to cause the cancer to spread.
Metastatic breast cancers come from breast cancer cells that remained in the body after treatment for early breast cancer. The breast cancer cells were always there but were dormant and could not be detected. For some unknown reason, the cancer cells began to grow again. This process is not well-understood.
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Metastatic Breast Cancer: What You Should Know
What does it mean to have metastatic, or stage 4, breast cancer? A Rogel Cancer Center oncologist explains the diagnosis and how its treated.
After hearing a diagnosis of metastatic breast cancer, a rush of questions emerges. But often, its not until long after leaving the doctors office.
Metastatic means the cancer has spread beyond the breast and immediate lymph nodes to other organs or tissues in the body, most often the bones, brain, lungs or liver. Its considered stage 4 breast cancer, which means the cancer has progressed to its most advanced stage.
But even though its moved to other organs, it still behaves like breast cancer and is treated with breast cancer therapies.
More than 154,000 U.S. women are estimated to have metastatic breast cancer, according to the Susan G. Komen organization. Men can have metastatic breast cancer too, but its rare.
To help patients fill in information gaps, N. Lynn Henry, M.D., Ph.D., the breast oncology disease lead for the University of Michigan Rogel Cancer Center, explains the nuances of stage 4 metastatic breast cancer.
What are the differences between metastatic breast cancer, stage 4 breast cancer and advanced cancer?
If any doctor uses the term advanced, ask for clarification, Henry adds.
When does metastatic breast cancer appear?
What are the symptoms?
Symptoms of bone metastases:
Can You Tell When Exactly My Breast Cancer Started
Often times, one of the most frequently asked questions I get when someone is diagnosed with breast cancer is when did it begin? says Roesch. And the general rule is that we really cant tell for sure when the cancer popped up. We can look at the subtype of breast cancer to perhaps get a better understanding if it was weeks vs. months for example, but theres no way to tell for sure.
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Can A Biopsy Make My Cancer Spread
A biopsy is an important part of helping your doctor make a possible cancer diagnosis. If your doctor does find cancer, the results of a biopsy can also help them tailor the right treatment plan for you and your specific type of cancer.
But some people may wonder whether a biopsy could have other effects on their body, including whether it may lead to the cancer spreading. Here, we discuss common biopsy techniques, why they are not likely to cause cancer to spread, and questions to discuss with your doctor if you have concerns.
What Are Breast Lobes And Breast Ducts
Each female breast contains 15-20 sections called lobes. Each lobe is made up of many smaller sacs called lobules . It is these lobules that produce milk in breastfeeding women. The lobes and lobules are connected to the nipple by tubes called ducts, which carry milk to the nipple. Milk flows through the nipple to the outside during breastfeeding.
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Everolimus And Hormone Therapy
Everolimus is an mTOR inhibitor. mTOR inhibitors are a class of drugs that may increase the benefit of hormone therapy.
Everolimus is FDA-approved for the treatment of hormone receptor-positive, HER2-negative metastatic breast cancers in postmenopausal women. The combination of everolimus and the aromatase inhibitor exemestane can slow the growth of such cancers better than exemestane alone .
Everolimus is a pill.
Some possible side effects include mouth ulcers, infections, rash, fatigue, diarrhea and decreased appetite.
In rare cases, it can cause lung inflammation, which can cause death. Tell your health care provider right away if you have shortness of breath or other breathing problems while taking this drug.
Adapted from select sources .
What Is Stage Iv Breast Cancer
Stage IV is the most advanced stage of breast cancer. It has spread to nearby lymph nodes and to distant parts of the body beyond the breast. This means it possibly involves your organs such as the lungs, liver, or brain or your bones.
Breast cancer may be stage IV when it is first diagnosed, or it can be a recurrence of a previous breast cancer that has spread.
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What Happens When Breast Cancer Spreads To Bone
Breast cancer that spreads to bones can destroy normal bone. Symptoms are pain, compromised mobility, fractures, spinal cord compression, and hypercalcemia, or too much calcium in blood. Hypercalcemia can be life threatening and may cause the following symptoms: headache and fatigue excessive thirst and urination nausea, vomiting, and constipation abnormal heart rhythm muscle cramping and weakness pain and fractures and memory loss, depression, and irritability.
Stem Cell Or Bone Marrow Transplant
A stem cell transplant, sometimes called bone marrow transplant, replaces damaged blood-forming cells with healthy ones. The procedure takes place following large-dose chemotherapy or radiation therapy to kill cancer cells and to stop your stem cells from producing cancerous cells.
Stem cell transplants can be used for several types of cancer, including multiple myeloma and some kinds of leukemia.
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What Is A Breast Cancer Recurrence
Breast cancer recurrence means that the cancer was diagnosed when limited to the breast and/or armpit lymph nodes, then treated, and at some time later has come back.
This can occur in several ways:
- Local and/or regional recurrence: the breast cancer that was previously treated returns within the breast, chest wall or regional lymph nodes.
- New primary breast cancer: an unrelated new breast cancer occurs in one or the other breast. This actually isnt a local recurrence at allits a new cancer in the breast . This typically occurs many years after the original cancer and in an entirely different area of the breast. Its pathology is often different lobular instead of ductal, for example. Though they are often counted as recurrences in the statistics for breast conservation, they should be treated as completely new cancers, much as with new cancers in the opposite breast.
- Distant or systemic recurrence or metastasis is much more serious than local recurrence and is synonymous with stage 4 disease. For breast cancer patients, the most common areas of spread are the bone, liver, lungs and brain
Breast cancer recurrence occurs if:
- Cells from the original breast cancer diagnosis break away and hide nearby in the breast or spread elsewhere in the body
- Treatment, including surgery, chemotherapy, radiotherapy and/or hormone therapy have not gotten rid of all these cancer cells from the body.
What Is Being Done To Help People With Metastatic Breast Cancer
While metastatic breast cancer cant be cured as of today, survival time has increased dramatically. Finding a cure for metastatic breast cancer is a top priority for many of the nations leading clinical researchers. Refer to the Susan G. Komen website to find a local affiliate, obtain educational materials, learn about additional resources, and become informed about clinical trial opportunities.
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What Is My Prognosis
This is a very common question that isnt always easy to answer. There are many factors involved in working out prognosis. Remember that a prognosis is just a figure at the point at which you receive it. For most people, the prognosis gets better with time.
Sometimes we use a five-year figure because we know that if cancer comes back, most of the time it comes back within five years. If the cancer has not come back within five years, then the chance of it coming back within ten years is quite low, and if it does not come back within ten years, then you have an almost normal life expectancy.
Its a bit like buying a second hand car. You dont really know how long its going to last, but if it lasts year after year without breaking down, then the car starts to look more and more reliable to make that long trip.
Working out prognosis can be difficult.