Metastatic Breast Cancer (Stage IV) is the cancer that has metastasized, which means that it has travelled to other parts of the body, most commonly the liver, lungs, brain, and bone. Cancer spreads through the bloodstream or lymphatic system, the large networks of nodes and vessels that works to remove viruses, bacteria, and cellular wastes products.
According to breastcancer.org, nearly 30% of women diagnosed with early-stage breast cancer will develop metastasized breast cancer. Some people are diagnosed with metastasized breast cancer when they are diagnosed for breast cancer for the first time, and this is called “de novo metastatic”, meaning the cancer in the breast was not detected before it spread to other parts of the body.
A patient who completes treatment for early or locally advanced breast cancer has the chance of developing metastasis breast cancer after years. This is sometimes called a “distant recurrence”. It happens due to breast cancer cells that remained after the treatment of early breast cancer. Breast cancer cells that were always present, were inactive and could not be detected but begin to grow again for some unknown reason.
The Risk
In 2020, it is estimated that there will be more than 168,000 women living with metastatic breast cancer in the U.S. (www. komen.org). Men also can get metastatic breast cancer.
The risk of developing metastasis breast cancer varies from person to person after the breast cancer treatment. It depends on:
- The characteristics of the cancer cells.
- How the cancer grows, which means is it faster growing or a slower growing cancer?
- The stage at the time of original diagnosis.
- The treatment for the original cancer.
Symptoms
The symptoms of metastatic breast cancer may vary depending on the location it spreads. It can spread to bone, lungs, brain, and liver.
Metastasis in the bone can show symptoms such as:
- Severe pain
- Fractures
- Decreased alertness due to high calcium levels
- Swelling
Metastatic breast cancer most often spreads to spine, pelvis, ribs or the long bones in the hands and legs.
Metastasis in the lungs can show symptoms such as:
- Difficulty in breathing
- Persistence cough
- Chest pain
- Fatigue
Metastasis in the brain can show symptoms such as:
- Headache
- Changes in speech or vision
- Seizures
- Vomiting or nausea
Metastasis in the liver can show symptoms such as:
- Jaundice
- Nausea
- Fatigue
- Swelling of the feet and hands
- Weight loss or poor appetite
- Fever
- Itchy skin or rash
Diagnosis
Tests for diagnosis of metastatic breast cancer are performed only when the doctor thinks that the cancer may have spread. The doctor will check the patient’s tumor size, lymph node spread and the specific symptoms the patient is having. The most common tests performed are:
- MRI scan
- Ultrasound scan
- Chest X-ray
- Bone scan
- CT scan
- PET scan (positron emission tomography)
The test depends on the medical history and symptoms of the patient. That means, if the doctor thinks that the cancer may have spread to patient’s abdomen, the patient may have an ultrasound scan. All these tests are relatively non-invasive and does not require hospital stay. Before any tests, patient will be given special instructions.
Treatment
Metastasis or Stage 4 breast cancer cannot be cured. However, it can be treated to focus on extending and improving the quality of life. The treatment plan depends on many factors including the biology of the tumor, the area where cancer has spread, the symptoms, and past breast cancer treatments. The main forms of treatment in this stage include:
- Chemotherapy
- Radiation therapy
- Hormone therapy
- Targeted therapy
- Surgery
- Pain management
- Clinical Trials
Metastatic breast cancer is considered incurable. However, advances in treatment coupled with state migration due to improved imaging and diagnostics have resulted in significantly longer survival in the last few years. When the disease is under control and the patient is feeling good, taking break in treatments can make a huge difference to their quality of life.
