Metastatic (stage 4) breast cancer

Finding out you have metastatic breast cancer may be overwhelming and scary. Our breast cancer team is here to help you manage this ongoing disease. At Penn Medicine, we offer comprehensive care for metastatic breast cancer that includes advanced imaging, innovative treatments, and specialized support services through our Breast Cancer Program.

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.

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.

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 include various options. 

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.

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.