Metastatic Breast Cancer

The most frightening words imaginable for any woman are those when she is told that she has breast cancer. The morbid thoughts run through her head and the fear is overwhelming. Now she must endure medical treatments and examinations for several months as begins her battle against this disease.

When cancer cells break away from the originally affected site, and spread to other parts of the body through the blood or lymphatic system, this is referred to as metastatic cancer. When the original cancer site – or primary site, as it is referred to by physicians – is the breast – and cancer cells spread from this location – this becomes known as metastatic breast cancer. The cancer that has moved from the breast and developed in other locations becomes known as the secondary cancer.

What is metastatic breast cancer? Also called Stage IV breast cancer, it is cancer that has spread from the original (primary) site to other organs or tissues in the body, such as bone, liver, lungs or brain.

The most common places for breast cancer to spread are within the breast or to the nearby chest wall or to the liver, lungs, or bones. Common symptoms include a lump in your breast or on your chest wall, bone pain, or shortness of breath. It is also possible that you will not have any symptoms and that the only way to keep yourself healthy is to be proactive and to take an active role in your health care. It may be necessary to have continuous laboratory tests and x-rays to determine whether or not the cancer has spread.

The most common secondary locations are the lungs, brain, liver, and bones. Metastatic breast cancer is certainly not confined to these locations and not all may be affected; these are statistically the most frequently affected areas. However it is not defined as cancer that has spread to any places close to the breast such as skin, muscles underneath or around the breast, or bones nearby the primary cancer location.

Treatment choices may include surgery, medicines like chemotherapy or hormone therapy, and radiation. Sometimes a mix of these treatments is used and there can be side effects. Your doctor can tell you what problems to expect and can help you find ways to manage and live with them during the treatment phase.

If it is “estrogen-receptive,” hormonal therapies such as the drug Herceptin can be lifesaving. Chemotherapy is indicated in bone, lung and liver metastases. For bone metastases, radiation and the drug bisphosphonate are often used. For liver and lung metastases, occasionally surgery is used. For cancer that has spread to the brain, radiation and surgery are used.

North American white women have the highest rates of breast cancer in the world, but the 5-year survival rate for all stages (Stage 1, Stage 2, Stage 3, and Stage 4) combined is 88% for the U.S. A recent study found European countries have lower 5-year breast cancer survival rates, with England at 77.8% and Ireland at 76.2% (Lancet Oncology). The difference in these survival rates is usually attributed to life-saving early detection.

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