> Metastatic Breast Cancer (Stage IV or Advanced Breast Cancer) Introduction
Metastatic breast cancer (also called stage IV or advanced breast cancer) is breast cancer that has spread beyond the breast to other organs in the body (most often the bones, lungs, liver or brain).
Although metastatic breast cancer has spread to another part of the body, it is considered and treated as breast cancer. For example, breast cancer that has spread to the bones is still breast cancer (not bone cancer) and is treated with breast cancer drugs, rather than treatments for a cancer that began in the bones.
Some women have metastatic breast cancer when they are first diagnosed, but this is not common in the U.S. (fewer than five percent of diagnoses) .
More commonly, metastatic breast cancer arises months or years after a person has completed treatment for early or locally advanced (stage I, II or III) breast cancer. This is sometimes called distant recurrence. The risk of breast cancer returning and metastasizing varies from person to person and depends greatly on the biology of the tumor and the stage at the time original diagnosis.
Learn more about breast cancer staging.
Learn more about breast cancer recurrence.
Treatment for metastatic breast cancer
As hard as it is to hear, metastatic breast cancer cannot be cured. Unlike breast cancer that remains in the breast or nearby lymph nodes, you cannot get rid of all the cancer that has spread to other organs. This does not mean, however, that metastatic breast cancer cannot be treated.
Treatment of metastatic breast cancer focuses on length and quality of life. Your treatment plan is guided by many factors, including:
- Characteristics of the cancer cells
- Where the cancer has spread
- Your symptoms
- Past breast cancer treatments
If the cancer is hormone receptor-positive, the first treatment is hormone therapy (learn more). If the cancer is HER2/neu-positive, anti-HER2/neu drugs such as trastuzumab (Herceptin) may be given (learn more).
Chemotherapy and radiation can be used to shrink or slow the growth of tumors or to ease symptoms of the cancer itself (learn more). However, these therapies have side effects that can affect quality of life.
Talking openly about quality of life issues with your health care providers and your family can help you decide what treatments are best for you. Joining a support group may help you think through these issues.
Learn more about treatment for metastatic breast cancer.
Learn more about quality of life.
Learn more about support groups and other sources of support.
Prognosis for metastatic breast cancer
Survival for metastatic breast cancer varies greatly from person to person. One large study found that about 15 percent of women lived at least five years after diagnosis with metastatic breast cancer . Some women may live 10 or more years beyond diagnosis . It is important to note that all these findings are based on women diagnosed before some of the newer treatments for metastatic breast cancer were available. Modern treatments for both early stage and metastatic breast cancer likely mean improved survival for women diagnosed today.
Treatment guidelines for metastatic breast cancer
Although the exact treatment for metastatic breast cancer varies from person to person, guidelines help ensure quality care. These guidelines are based on the latest research and the consensus of experts. The National Comprehensive Care Network (NCCN) and American Society of Clinical Oncology (ASCO) are two respected organizations that regularly update and post their guidelines online. The National Cancer Institute (NCI) also has overviews of treatment options.
In 2013, the Institute of Medicine (IOM) released a set of recommendations (below) on improving cancer care in the U.S. The report Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis recommends improvements to fix shortcomings that add cost and burden to cancer care. Susan G. Komen® was one of 13 organizations sponsoring this study.
The report identified key ways to improve quality of care:
- Ensure that cancer patients are engaged and understand their diagnoses so they can make informed treatment decisions with their health care providers
- Develop a trained and coordinated workforce of cancer professionals
- Focus on evidence-based care, using information technology to provide better information about the potential benefits of treatments
- Focus on quality measurements
- Provide accessible and affordable care for all
Read the full report at www.nas.edu and www.iom.edu.
*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.