Symptoms Of Metastatic Breast Cancer
The symptoms of stage 4 breast cancer depend on the location of the cancer and where it has spread in your body.
- If breast cancer has spread to your bones, you may notice a sudden new bone pain. Breast cancer most commonly spreads to your ribs, spine, pelvis, or arm and leg bones.
- If it has spread to your brain, you may experience headaches, vision or speech changes, or memory problems.
- Breast cancer that has spread to your lungs or liver usually causes no symptoms.
The main treatments for stage 4 breast cancer are targeted drug therapies that destroy cancer cells wherever they are in your body.
These treatments may include:
- hormone therapy, which stops or slows the growth of tumors by preventing your body from producing hormones or interfering with the effect of hormones on breast cancer cells
- chemotherapy, where drugs given orally or through an IV travel through your bloodstream to fight cancer cells
- immunotherapy, which uses drugs that stimulate your immune system to destroy cancer cells
- a combination of these therapies
In some cases, surgery or radiation therapy may be used to treat stage 4 breast cancer.
The following are the common treatment options for different types of stage 4 breast cancer.
How To Cope With Metastatic Breast Cancer
Metastatic breast cancer does not always develop because you have taken the wrong treatments or have been irregular with your treatment. There are reports of women developing cancer after being disease-free for months and years. Even after medications and surgeries, there are chances that some cancer cells are still present. These cells migrate to organs, leading to the metastatic condition.
The time when your doctor reveals to you that you have reached an advanced stage of cancer can be emotionally devastating. However, you need to accept the conditions and prepare yourself to explain the same to your loved ones. It is OK to take some time and find the right time to share the news with them.
The treatment for metastatic breast cancer is an ongoing treatment and evolving through clinical trials. There is no hope for a cure. However, medications can help you deal with the symptoms and live a longer life than without the treatment.
You may decide to stop the medications for metastatic breast cancer because of the severe side effects that come with the treatment. You may opt for hospice or palliative care, which is available in many hospitals. Palliative care is a special kind of treatment reserved for people with a terminal illness. It aims to alleviate the symptoms, as well as provide you comfort and better quality of life.
There Are Good Days And Bad Days
There are days when I say to myself, Ive had enough. I cant take it anymore, says Rosen. But I want to keep on living. I love my life. Overall, I have a great life except for the cancer.
Rosen has a few mantras she uses when things get tough. A lot of the tough times are treatment related, she says. I refer to those as bumps in the road, and , This too shall pass.
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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.
Myth #: When Breast Cancer Travels To The Bone Brain Or Lungs It Then Becomes Bone Cancer Brain Cancer Or Lung Cancer
Not true. Breast cancer is still breast cancer, wherever it travels in the body. However, the characteristics of the cells can change over time. For example, a breast cancer that tested negative for hormone receptors or an abnormal HER2 gene might test positive when it moves to another part of the body, or vice versa . Keep in mind that the cancer cells are trying to survive in the body, so they can change, says Dr. Gupta. We always emphasize rechecking the biology.
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Health & Wellnesswhat Women Under 40 Should Be Doing To Detect Breast Cancer
While Cramer said she did not have any these risk factors, she was proactive about doing breast examinations and talking to a doctor when she noticed something felt off. Sardesai said that women who observe differences in their breast should talk to their doctor immediately.
I would say it is a very high priority, Sardesai said. Its very important for the doctors to listen to their patients and not ignore their symptoms just because theyre younger.
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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Many With Incurable Cancer Think They Can Be Cured
Majority of Advanced Cancer Patients Believe Chemotherapy Can Cure Them
Oct. 24, 2012 — It is not a desired discussion for the doctor, and certainly not for the patient. But an overwhelming majority of people with advanced cancer are under the impression that the chemotherapy they are receiving will cure their disease when it likely will not, a new study shows.
In these scenarios, chemotherapy can alleviate pain and extend life by weeks or even months. It canât cure advanced cancer.
The disconnect may be related to how doctors discuss treatment options with people who have advanced cancer, and/or the people receiving this news may be in a state of denial about their illness.
Researchers at the Dana-Farber Cancer Institute in Boston interviewed 1,200 people with metastatic colon or lung cancer — cancer spread to distant organs — about their chemotherapy. Almost 70% of people with advanced lung cancer and 81% of those with advanced colorectal cancer inaccurately believed that chemotherapy could likely cure them.
The findings are published in the New England Journal of Medicine.
Breast Cancer Survivor Fights For Rare Implant Surgery Using Own Body Tissue
When Cramers cancer returned it looked like mosquito bites and Sardesai said doctors also need to remember breast cancer doesnt always look one way.
Breast cancer can present in many ways. Its not always just a lump. It can be a nipple discharge, soreness in the breast, skin changes, he said. If it’s a young woman who presents with any of these symptoms they should not be dismissed.
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What Is Metastatic Breast Cancer
Metastatic breast cancer is breast cancer which has spread beyond the breast and nearby lymph nodes to other parts of the body. Metastatic breast cancer often but not exclusively spreads to the bones, lungs, liver or brain. Some people assume if breast cancer spreads for example to the lungs that the patient has both breast cancer and lung cancer. This is usually incorrect. It is still breast cancer, just no longer in the breast, and treatments are directed to breast cancer.
Here’s Why I’m Sharing My Secret
I’ve decided to tell my secret for two reasons. The first is that I realized that much of my initial despair was based on bad information. I was wrong about almost everything. So maybe my confession will shorten the Despair Phase for others.
The second reason is much more in my wheelhouse as a journalist: outrage. I’ll get to that in a moment. But first, my mistakes.
I thought metastatic breast cancer was fairly rare. Nope. Up to 30% of women with early stage breast cancer progress to stage 4. I thought that you were more likely to get metastatic breast cancer if you’d been diagnosed with a more-advanced stage of breast cancer to begin with. Wrong again. It’s not dependent on your stage at original diagnosis. I was stage 1B when I was first diagnosed in January 2012.
I thought it was my fault. Maybe I drank too much . Or gained too much weight .
Those are among many factors that can influence whether you get breast cancer initially. But no one is sure what causes metastases. So again, wrong, wrong, wrong.
Unfortunately, I did have something mostly right. The five-year relative survival rate is about 1 in 4.
And it’s worse for Black women. Due to the types of cancers that they get, African American women have the highest breast cancer mortality rate of any U.S. racial or ethnic group, at 26.8 per 100,000 annually.
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When You Live With Metastatic Cancer
When you live with cancer for many months or years, doctors often treat it like a chronic, or long-term, illness. Like someone with any chronic illness, such as diabetes or heart failure, treatment is important.
It is important to follow your treatment plan so it works as well as possible. You also need support for the physical, emotional, and social effects of living with cancer.
Surviving Stage 4 Breast Cancer: Is It Possible
Understanding survival rates of stage 4 breast cancer
According to the National Cancer Institute , an estimated 27 percent of people in the United States live at least 5 years after being diagnosed with stage 4 breast cancer.
Many factors can affect your longevity and quality of life. Different subtypes of breast cancer behave differently. Some are more aggressive than others, and some have far fewer treatment options than others. For this reason, your subtype may affect your outlook.
Higher survival rates are also associated with the extent and location of metastasis. In other words, your long-term outlook may be better if your cancer has only spread to your bones than if its found in your bones and lungs.
Immediately seeking treatment, like chemotherapy, surgery, or hormone therapy, can help improve your outlook. Making healthy lifestyle choices might also improve your chances of survival.
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Clinical Trials Are A Promising Treatment Option
For people with advanced stages of cancer, clinical trials can be considered the gold standard of treatment. I recommend clinical trials highly, says Rosen. You get access to medication and treatment that you normally wouldnt have.
A clinical trial could even have positive results on your cancer. We are living in an exciting time for cancer treatment, says Kimmick. There are myriad new drugs coming out that will improve the lives of all women with breast cancer, both metastatic and early stage.
However, its important to be realistic about the potential outcome of your trial. Rosen was recently enrolled in a clinical trial in which the medication proved toxic for her. But she has no regrets about participating. It feels like Im helping researchers who are working on cures for cancer, she says. When I had a bad reaction to the drug, they were able to put my side effects in their study. I feel like I did help, and that makes me happy.
People interested in joining a clinical trial for treatment should talk to their doctor about options that might be good for them.
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When she had her mastectomy in January 2014, they found the cancer had spread to her lymph nodes. She went through 16 weeks of chemotherapy, a bilateral mastectomy, reconstructive surgery and radiation. After treatment, scans didnt show any cancer and she enjoyed life without the invasive treatments and too frequent doctors visits.
2015 to 2018 were good years, where I didnt really have anything going on, she said.
She enjoyed spending time with her sons, now 13, 10 and 8, watching their sporting events or swimming with them. While she felt healthy for the most part, she was working with a physical therapist for issues with the irradiated tissue, tissue that was injured by radiotherapy treatment. The therapist noticed two bumps on her skin, near an incision close to her armpit, in late 2018.
They were kind of like mosquito bites, she explained. I knew I was going to the doctor in February so I just had them look at them then.
The doctor wasnt worried so she resumed normal life. By April though, it appeared the bumps were abnormal. They weren’t going away, so she followed up with a different doctor.
I started to freak out, she said. They did a second biopsy and after a couple of weeks of trying to figure out what was going on it came back as triple negative breast cancer.
I was considered metastatic, stage 4, she said.
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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:
What Should I Ask My Healthcare Provider About Metastatic Breast Cancer
If youve been diagnosed with metastatic breast cancer, ask your provider:
- What are my treatment options?
- What is my prognosis?
- What side effects can I expect?
- Will complementary therapy help me feel better?
- What if I want to stop treatment?
- How can I feel my best during treatment?
A note from Cleveland Clinic
Metastatic breast cancer is advanced breast cancer. Providers classify it as stage 4 breast cancer. It happens when cancer cells, often left behind after previous breast cancer treatment, start to spread to other parts of the body. While there is no cure for metastatic breast cancer, treatment can prolong your life and help you feel better. There are many medications available, so if one treatment isnt working, your care team can try a different approach. If you notice any symptoms or dont feel your best, especially if youve undergone breast cancer treatment in the past, talk to your healthcare provider.
Last reviewed by a Cleveland Clinic medical professional on 04/14/2021.
References
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Living With Secondary Breast Cancer
You will see your cancer doctor or specialist nurse regularly during and after treatment. This means that any symptoms or problems can be managed early on. You may have regular scans to check how the cancer has responded to treatment.
You may need treatment at different times or have ongoing treatment with hormone therapy. There may be long periods when the cancer is controlled and you are getting on with day-to-day life.
We have more about well-being and coping in our information about living with secondary breast cancer.
You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation. Macmillan is also here to support you. If you would like to talk, you can:
Why Does My Provider Need To Test The Metastatic Tumor
Your care team will test the metastases to figure out the biology of the tumor, which can help guide your treatment plan. Providers may test tumors for:
- Hormone receptor status: If the cancer is hormone receptor-positive, hormonal therapy may be your first treatment.
- HER2 status: Human epidermal growth factor receptor 2 is a protein that is overexpressed on some breast cancer cells. HER2-positive cancer responds to specific HER2-targeted therapies.
- PIK3CA gene mutation: If a tumor is hormone receptor-positive and HER2-negative, your provider may test for this gene mutation. Specific targeted therapies can be used to treat tumors with this mutation.
- PD-L1 status: Tumors that are hormone receptive-negative and HER2-negative may be tested for PD-L1 status. If the PD-L1 test is positive, you may be recommended to receive a combination of immunotherapy and chemotherapy.
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How Is Metastatic Breast Cancer Diagnosed
The signs and symptoms of metatstatic breast cancer can be non-specific and mimic other conditions. A study by Breast Cancer Now in 2019 showed that one in four people with metastatic breast cancer visited their GP three or more times before being diagnosed. In 20% of patients, their metastatic disease was misdiagnosed and they were being actively treated for other conditions. Around 40% of patients felt their concerns were not taken seriously. These were mainly women with a documented history of primary breast cancer. Some patients symptoms were so severe that they were diagnosed in A& E.
Many patients feel that once they reach five years clear of a primary diagnosis, they are very unlikely to develop metastatic breast cancer. Some doctors are also not vigilant for metastatic disease after five years have passed from initial diagnosis. Unfortunately, the risk of recurrence carries on beyond five years. It is for this reason that oncologists are increasingly prescribing hormonal therapy for estrogen receptive cancer for 10 years.
According to Breast Cancer Now patients with a history of primary breast cancer should seek medical advice if they experience any of the following persistent symptoms. Many oncologists define persistent as being for two weeks.