Metastatic breast cancer

Breast cancer typically starts when cells in the breast begin to grow uncontrollably, forming a tumor. If not caught early, these cancer cells can travel through the bloodstream or lymphatic system to create new tumors in other organs or tissues. This is known as metastatic breast cancer – the most advanced and aggressive stage of breast cancer.

Metastatic breast cancer typrically spreads to the bones, liver, lungs or brain. Because of it’s advanced spread, it has a less favorable prognosis compared to other types of breast cancer.

However, various factors can change your prognosis, including where the cancer has spread, how it responds to treatment and your overall health. Following your treatment plan also helps manage the spread of cancer and alleviates your symptoms.

Risk factors of metastatic breast cancer

There are several factors that may increase your risk of developing metastatic breast cancer. While breast cancer is more commonly associated with women, men can also develop it. Regular self-exams and annual mammograms are essential for early detection, which can significantly impact your outlook.

Other risk factors of metastatic breast cancer include:

• Previous breast cancer diagnosis: Increases the chances of recurrence and spread.
• Age: Your risk rises with age, particularly after menopause.
• Genetic factors: Mutations in genes like BRCA1 and BRCA2 can significantly raise your risk.
• Family history: A history of breast cancer or other cancers in your family may indicate a higher risk.
• Lifestyle factors: Obesity, alcohol consumption and lack of physical activity may also contribute to your cancer risk.

Stages of breast cancer

Upon diagnosis, doctors assign a stage and grade to the tumor. This helps create a personalized treatment plan for you. Breast cancer stages range from 0 to 4:

• Stage 0: Non-invasive cancer confined to the ducts or lobules in the breast. This stage is also known as ductal carcinoma in situ.
• Stage 1: Early-stage cancer that's small and confined to the breast.
• Stage 2: Larger tumors or cancer have spread to nearby lymph nodes.
• Stage 3: Cancer has spread to several nearby lymph nodes or surrounding tissues.
• Stage 4: Metastatic breast cancer, with cancer has spread to distant parts of the body.

Signs of metastatic breast cancer

It’s important to understand the signs of breast cancer, especially any early signs.

Common signs include:

• Bone pain, particularly in the back, hips, or ribs.
• Unexplained weight loss.
• Shortness of breath, especially if the cancer has reached the lungs.
• Fatigue that doesn't improve with rest.
• Jaundice, indicating potential liver involvement.
• Neurological symptoms like headaches or seizures if the cancer has spread to the brain.

Schedule an appointment with your doctor if you notice any changes in your health or experience symptoms.

Diagnosing metastatic breast cancer

A breast cancer diagnosis involves a series of exams, imaging tests, biopsies and blood tests. This helps determine the extent of cancer spread and rule out any other potential causes of your symptoms.

Your doctors will begin with a physical exam, followed by imaging tests such as a mammogram, CT scan, MRI, bone scan and PET scan to detect abnormalities.

If abnormalities are found, a biopsy will follow to confirm or deny your diagnosis. Blood tests, such as a complete blood count and liver function tests, provide further insights into any affected areas.

What should you do when diagnosed with metastatic breast cancer?

It may be hard to know where to start when you received a breast cancer diagnosis. That’s why it’s important to work with a care team that provides clear and accessible information.

After your initial diagnosis, a second opinion from a surgeon specializing in your type of breast cancer is crucial for accurate treatment. You’ll also want to find an oncologist who specializes in metastatic breast cancer. They can help you explore treatment options, including possible clinical trials.

Supportive care services like counseling, nutrition therapy, palliative care and physical therapy can also help address the physical and emotional impact of cancer treatments.

Is metastatic breast cancer curable?

Metastatic breast cancer is not considered curable, but it is treatable. Advances in medicine have made it possible to manage cancer more effectively, focusing on controlling its spread, alleviating symptoms and maintaining the best possible quality of life for you.

Metastatic breast cancer treatment

Treatment aims to control the disease and improve quality of life, with options including:

• Surgery: Since metastatic breast cancer often spreads to more than one area, doctors typically don’t recommend surgery. Sugery may be recommended to target specific areas. For example, if a tumor is on your liver, they may perform surgery to remove tumors on your liver so it can function the way it is supposed to.
• Targeted therapy: Certain cancers express specific targets that can be addressed with targeted medications. These drugs aim to disrupt the formation of new blood vessels, which slows tumor growth.
• Chemotherapy: Chemotherapy is given for more aggressive cancers like metastatic breast cancer, usually before surgery to shrink the tumor and slow the spread.
• Radiation therapy: Following surgery, radiation therapy may be given to kill any leftover cancer cells in the breast and reduce the risk of recurrence.
• Hormone therapy: Is used to block or reduce estrogen to stop the growth of the tumor.