Metastatic breast cancer is breast cancer that has spread from the breast to other parts of the body. This is also referred to as advanced or stage 4 breast cancer. Metastatic breast cancer can spread to any part of the body, though it most often spreads to the bones, liver, lungs, and brain.
While metastatic breast cancer usually cannot be prevented or cured, it can be treated. If you are diagnosed with metastatic breast cancer, your cancer care team will design a treatment plan to slow the growth of your cancer or relieve symptoms. Patients can live long, full lives with metastatic breast cancer. Currently, research is being done on treatments that may prevent cancer from spreading or returning.
Why Does Breast Cancer Metastasize?
Breast cancer metastasizes when cancer cells spread to lymph nodes or blood vessels near the initial cancer site. The cancer cells then travel to other parts of the body through the lymphatic system or the bloodstream and grow in a different part of the body. Even after the cancer has spread, it is still referred to and treated as breast cancer because it is made up of breast cancer cells.
In most cases, metastatic breast cancer occurs after an initial diagnosis at an earlier stage. Sometimes, treatment does not destroy all the cancer cells, and they begin to grow and spread again. In some cases, breast cancer has already spread before the initial diagnosis. This is called “de novo” metastatic breast cancer.
Regardless of when metastatic breast cancer is diagnosed, metastatic breast cancer does not happen because of something the patient did.
What Symptoms Will I Experience with Metastatic Breast Cancer?
The signs and symptoms that your cancer has metastasized may depend on where your cancer has spread and how much it has grown. If you have breast cancer and are experiencing the following symptoms, please discuss with your doctor:
- Bone metastasis symptoms may include pain in the bones, back, neck, or joints, bone fractures, or swelling.
- Brain metastasis symptoms may include headache, nausea, seizures, dizziness, confusion, changes in vision, changes in personality, or loss of balance.
- Lung metastasis symptoms may include shortness of breath, difficulty breathing, or a constant dry cough.
- Liver metastasis symptoms may include yellowing of the skin or whites of the eyes, itchy skin, pain or swelling in the stomach, loss of appetite, or nausea.
Other symptoms may include weight loss, vomiting, or fatigue. Your physician may also see high enzymes on a liver test or signs of a problem on a chest x-ray. If your doctor suspects your breast cancer has metastasized, they may recommend blood tests, imaging studies, a bronchoscopy to look at your lungs, or a biopsy of suspicious tissue to make a diagnosis.
I Have a Diagnosis. What Should I Ask My Cancer Care Team?
Receiving a metastatic breast cancer diagnosis may feel overwhelming. Asking questions and having discussions about your diagnosis and treatment with your cancer care team can help you better understand your diagnosis and care. Making informed decisions about your care is an important part of your cancer care treatment. Your team wants to help you develop a plan that best fits your needs.
You may want to ask your doctor:
- What kind of prognosis can I expect? Is there anything I can do to improve my prognosis?
- Are clinical trial options available for me?
- Will I need additional tests or procedures before we can develop a treatment plan?
- What are the goals of the recommended treatments?
- What are the risks or side effects of the recommended treatments?
- How will we know if the treatment is working?
- When do I need to make a treatment decision?
- What will happen if the treatment stops working, or if I chose to stop treatment?
- What kind of support will I need from family or caregivers?
- Would you recommend seeking a second opinion?
It may be helpful to write down your questions ahead of time and take notes while speaking with your doctor. You may also want to bring a friend or family member with you for support.
What Are My Treatment Options for Metastatic Breast Cancer?
Metastatic breast cancer is usually treated with medications that treat cancer throughout the entire body. Your cancer care team will work together to create a treatment plan tailored to your cancer type and where the metastasis has occurred. The goals of metastatic cancer treatment are to make sure the patient lives the longest and best quality of life possible with the fewest possible side effects from both the cancer and the cancer treatment.
Treatment Options for Metastatic Breast Cancer May Include:
- Chemotherapy: Chemotherapy is used to damage the metastasized breast cancer cells as much as possible.
- Radiation Therapy: While radiation therapy is not always used for metastatic breast cancer, your physician may recommend radiation therapy to help ease pain or other symptoms or to control cancer growth in a specific area.
- Hormonal Therapy: These medicines are used for treatment of hormone receptor-positive metastatic breast cancer to help shrink or slow cancer cell growth.
- Targeted Therapies: These treatments target specific characteristics of cancer cells to stop growth.
- Local Treatments: Your doctor may recommend treatments delivered to specific locations the breast cancer has metastasized to if the cancer is causing pain or other symptoms.
Talk to your doctor about the goals of each recommended treatment and what you can expect during the treatment. Take time to learn about all your treatment options, and don’t be afraid to ask questions. Your cancer care team is there to help you make the best decisions for you.
Take Care of Yourself While Living with Metastatic Breast Cancer
Medical treatment can play an important part in length and quality of life after a metastatic breast cancer diagnosis, but it is also important to take care of your other physical and emotional needs. Your cancer care team can help you with resources for your nutritional needs, stress management, support groups, mental health services, and regular exercise. You may also want to explore complementary therapies that help lessen side effects and improve your quality of life. This may include yoga, acupuncture, massage, or meditation.