Finding out you have metastatic breast cancer can feel overwhelming and frightening. It brings a unique set of emotional, physical, and medical challenges. However, it is important to know that you do not have to walk this path alone.
At Penn Medicine, we view metastatic breast cancer as a manageable, ongoing chronic disease. Our dedicated breast cancer care specialists provide you with steady, comprehensive care from day one, focusing on controlling the cancer, relieving symptoms, and maximizing your quality of life.
What is metastatic breast cancer?
Metastatic breast cancer, classified and referred to as stage IV breast cancer, is a late-stage form of breast cancer in which the cancerous cells have spread (metastasized) beyond the breast. All types of breast cancer begin in the breast tissue, but the breast cancer diagnosis becomes more serious once the cancer is no longer localized to one area (such as the breast). This happens when breast cancer cells travel through the bloodstream or lymphatic system.
Breast cancer most commonly spreads to the bones, lymph nodes, lungs, liver, and brain. In more than half of metastatic breast cancers, the cells spread to bones first. No matter where a metastatic tumor is found, it contains breast cancer cells and is considered breast cancer.
If breast cancer is not detected before it spreads, stage IV breast cancer may be your first diagnosis. In other cases, stage IV breast cancer may reoccur elsewhere in your body months or years after an initial diagnosis. About 30 percent of early-stage breast cancers return as metastatic disease.
Signs of metastatic breast cancer
Metastatic breast cancer symptoms depend on where the cancer is discovered. Common locations and symptoms include:
- Bone: Symptoms can include a severe new bone pain that gradually becomes constant. Bone metastases can also cause fractures.
- Brain: Signs can include headaches, nausea, facial numbness, and changes in speech, vision, or balance.
- Liver: Liver metastases rarely produce symptoms. When they occur, symptoms can include pain in the right side of the abdomen, weakness, poor appetite, and yellowing of the eyes and skin.
- Lungs: Signs of lung metastases include lung pain, shortness of breath, and persistent cough.
Metastatic breast cancer diagnosis and staging
We use leading-edge breast imaging technology to understand the spread of breast cancer. Our specialized radiologists identify the location of the cancer, see how far it has spread, and determine how well your treatment is working. Imaging for metastasized breast cancer can involve various types, including CT scans, MRI scans, PET scans, bone scans, and biopsy tissue sampling.
Stage IV breast cancer prognosis
Metastatic breast cancer is always considered advanced stage IV breast cancer because it has spread (metastasized) to different organs or lymph nodes far from the breast. The most common areas of the body that cells may spread to are the brain, bones, liver, and lungs.
There is no known cure for metastatic breast cancer. Once cancer cells have spread to other areas of the body, it is not possible for them all to be removed. Therefore, your care team may choose to focus your treatment on shrinking tumors, slowing their growth, relieving symptoms, and improving your quality of life.
At Penn Medicine, our team of expert clinicians have access to industry-leading breast cancer research and clinical trials that continue to advance the treatment and outcomes of those diagnosed with metastatic breast cancer. Your care team will be able to guide you in treatment options based on your specific diagnosis.
Metastatic breast cancer treatment and management
We understand that metastatic breast cancer is a disease you will actively manage for the rest of your life. Our breast cancer treatment goal is to control the cancer and help you maintain a good quality of life.
Systemic therapy (drugs that work throughout the body) is the primary treatment used for metastatic breast cancer. The type of medication used depends on whether a cancer is hormone receptor-positive or HER2-positive. Systemic therapy for advanced breast cancer can include:
- Chemotherapy uses drugs that can be taken orally or given intravenously (IV) to attack cancer cells.
- Targeted therapy is reserved for cancer that is hormone-positive, HER2-positive, or results from a BRCA gene mutation. This therapy is directed at a cancer cell’s hormone receptors to interrupt the abnormalities that drive cancer growth.
- Hormone therapy (also called endocrine therapy) may be used if breast cancer is hormone positive.
Immunotherapy (biologic therapy) is a breast cancer treatment that helps your immune system attack cancer cells. Immunotherapy is a new and promising approach that may benefit advanced cancer with characteristics including:
- Triple negative status
- Higher levels of PD-L1 protein in immune cells around the breast tumor
Penn Medicine is a leader in breast cancer research and clinical trials that offer a variety of promising studies for patients with metastatic breast cancer. Participating in a trial gives you access to innovative treatments and imaging studies. Your care team identifies trials that are appropriate for you.
Through our 2-PREVENT Breast Cancer Translational Center of Excellence (TCE), patients can access clinical trials and research with a focus on metastatic and recurring breast cancers. You can also search the Penn Medicine database of breast cancer clinical trials.
Metastatic breast cancer may cause pain and discomfort. Treatments such as radiation therapy and surgery for cancer help prevent or minimize more serious symptoms and complications of metastatic breast cancer. We offer breast cancer support services and integrative oncology to help with treatment side effects and non-medical issues.
Penn Medicine offers Unite for HER Virtual Wellness Days, where you can participate in a free interactive Wellness Day with a passport to access integrative services that may help relieve you of discomfort that symptoms are causing. This Wellness Day session will help you learn how integrative therapies can empower and restore you during your breast cancer journey.
Offering hope and advanced care for stage 4 breast cancer
We have the resources to identify metastatic breast cancer and get you the personalized treatment you need. At Penn Medicine, you can expect:
- Advanced imaging: We use imaging studies such as CT scans, bone scans, and nuclear medicine tests to identify metastatic breast cancer. Imaging specialists across the Penn Medicine network collaborate to provide the most accurate interpretation of your scans.
- Access to innovative clinical trials: We offer breast cancer clinical trials for patients diagnosed with metastatic breast cancer. These studies give you access to new and promising treatment and imaging.
- Personalized treatment: We use tumor profiling to understand the genes in cancer cells. This information helps us individualize targeted therapies and treatment for your disease.
- Care close to home: We care for metastatic breast cancer at all our Penn Medicine breast cancer locations. Oncologists and radiologists throughout our network collaborate seamlessly to get you the treatment you need.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.
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