Metastatic Breast Cancer
Metastatic breast cancer, classified as stage IV disease, is cancer that has spread beyond the breast into other areas of the body. Metastatic disease is usually diagnosed when breast cancer has recurred (returned), months or even years after treatment for earlier stage disease. Breast cancer is metastatic at the time of diagnosis in approximately 10% or less of women with breast cancer.
At one time, the prognosis (prediction of outcome) for women with metastatic breast cancer was poor. But through research and advances in treatment, women are living longer with metastatic disease. Studies have shown that new treatments have led to a 30% increase in the average survival for women with metastatic breast cancer. The duration of survival now varies widely, with some women living for 20 years or more after a diagnosis of metastatic breast cancer. The quality of life for women with metastatic breast cancer has also improved, and many women live full, active lives while being treated for the disease.
Development of Metastasis
Breast cancer metastasizes when cancer cells break away from the breast tumor and enter the bloodstream, where they can then travel to other parts of the body. The most common site of metastasis is bone; approximately one-quarter of breast cancers metastasize to bone first. The other frequent sites of metastasis (in order) are the lung, liver, and brain.
Metastasis is found either through routine follow-up tests or because of symptoms, such as bone pain or shortness of breath. Unlike earlier stage breast cancer, early detection does not usually make the disease easier to treat or control. Research has shown that the prognosis is not better if the metastasis is detected before symptoms occur.
Even though the cancer is now in a different organ, the cells are still breast cancer cells, and so many of the same treatments that are used for earlier stage breast cancer are used for metastatic disease, no matter where the metastatic lesions are located in the body. No current treatment cures metastatic breast cancer; treatment can only slow or stop the growth of the disease. Thus, the goal is to control breast cancer in much the same way as a chronic disease is controlled.
Women with metastatic breast cancer often feel alone and overlooked, as the focus seems to be on early detection, or finding breast cancer at an early stage, when the chance for cure is more likely. If you have metastatic breast cancer, you are not alone—more than 150,000 women in the United States are living with metastatic breast cancer. And the disease is not overlooked, with researchers working every day to improve treatments.
Women with metastatic breast cancer have said that one of their most difficult challenges is uncertainty. It is very difficult for doctors to predict survival for women with metastatic breast cancer. Every woman and every breast cancer is different. You can feel more in control by learning as much as you can about the specific characteristics of your breast cancer, your treatment options and ways you can help make yourself healthier—physically and emotionally. Hundreds of survivors have credited regular exercise, yoga, healthy nutrition, time with family and friends, support groups, and spirituality as helping them thrive during treatment for metastatic breast cancer.
This information is primarily for women who have metastatic breast cancer either as a new diagnosis or as recurrence of previous breast cancer. Family and friends of women with metastatic breast cancer can also gain insight and knowledge that will help them provide support to their loved ones.
In the pages that follow, you will find information about the treatment options for metastatic breast cancer, about tests used to assess whether treatment is effective, and about ways to manage the physical and emotional side effects of metastatic breast cancer. Throughout, you will be directed to Web sites where you can find more details to help you better understand metastatic breast cancer and living your life to the fullest in spite of it.