Sometimes, cancer spreads from where it originated to another area of the body. When this happens, it’s referred to as metastatic cancer. Metastatic breast cancer occurs when breast cancer has developed outside of the breast. Also called stage 4 breast cancer, metastatic breast cancer can affect any area of the body but typically spreads to the lungs, bones, liver, and brain. Learn more about breast cancer staging.
A metastatic breast cancer is serious and needs to be addressed quickly, but there’s no reason to feel hopeless. Many breast cancer treatment options are available, some specifically for metastatic breast cancer. Recent advancements in breast cancer treatments make it possible for many patients to live longer and fuller lives. Although metastatic cancer cannot be cured, the right treatment plan can help you manage it.
What Causes Breast Cancer to Metastasize?
Breast cancer that has already spread outside of the breast at the time of the patient’s initial diagnosis is called “de novo” metastatic breast cancer. This means the cancer was not detected before it spread to other areas of the body.
For patients who received an original breast cancer diagnosis of Stage 1, 2, or 3 and completed their treatment plans, the most common reason for metastasis is the growth of surviving cancer cells. At the conclusion of the original treatment plan, the cancer cells were undetectable in blood tests and images. However, these undetectable cells can develop into tumors in the same breast, other breast, or other areas of the body. The most common sites for metastasis include the bones, liver, lungs, and brain.
Metastatic breast cancer is still treated as breast cancer, even if it has spread to another area of the body. This is because the distant tumors are made of breast cancer cells. The recommended treatment plan will involve drugs and other therapies intended for breast cancer.
Very few patients develop a second, completely different type of cancer after breast cancer.
Signs That Breast Cancer Has Spread to Other Areas of the Body
Common symptoms associated with metastatic breast cancer are usually related to where the cancer has spread and how much it has grown. Be sure to talk with your breast cancer care team if you experience any of the symptoms listed below so they can treat them accordingly.
General signs of breast cancer growth can include weight loss, vomiting, and fatigue. More specific symptoms, which occur based on where cancer has spread, include:
- Bone metastasis could cause bone, back, neck, or joint pain, bone fractures, or swelling.
- Lung metastasis may cause shortness of breath, difficulty breathing, or a constant dry cough.
- Brain metastasis might cause headaches, nausea, seizures, dizziness, confusion, vision changes, changes in personality, or loss of balance.
- Liver metastasis can result in yellowing of the skin or whites of the eyes, itchy skin, pain or swelling in the stomach, loss of appetite, or nausea.
Sometimes, abnormalities are detected after follow-up tests, such as a chest x-ray or a liver enzyme test. When this happens, your doctor will likely require additional testing to make an official diagnosis.
Any follow-up visits with your breast cancer specialist will include blood work that looks for “tumor markers.” Increasing numbers mean that the cancer is likely growing again somewhere in the body. More tests will be needed to confirm this and identify the exact location.
Imaging tests like PET scans or MRIs may also be used to examine the whole body for signs of metastasis. The more your oncologist knows about any symptoms you’re experiencing, the easier it is to determine where to look first.
Metastatic Breast Cancer Treatment Options
There are several ways to treat metastatic breast cancer. Most of these treatments are considered systemic therapies because they treat cancer throughout the entire body. Several of these therapies have been recently approved specifically for stage 4 breast cancer patients whose cancer has returned.
Your oncologist will evaluate your case closely and then work with the rest of the cancer care team to develop a treatment plan. The goal of the breast cancer specialists at New York Oncology Hematology is to tailor it to your individual needs while also providing the best outcome.
Treatment Options for Metastatic Breast Cancer May Include:
- Chemotherapy damages the metastasized breast cancer cells that are located throughout the body.
- Hormone therapy blocks the hormone receptors in hormone receptor-positive metastatic breast cancer.
- Targeted therapies seek out cancer cells based on their specific characteristics. Genomic tests are performed to see if there are specific gene mutations. If present, a targeted therapy for the particular genetic mutation may be available.
- Immunotherapies trigger the immune system with checkpoint inhibitors to recognize and attack cancer cells. Immunotherapies continue to be a promising part of breast cancer research.
Surgery and radiation therapy are not common approaches to treating metastatic breast cancer. However, radiation therapy may be used to help reduce pain caused by distant tumors.
Clinical trials may be an option for some patients. Talk with your NYOH oncologist to learn more about our available metastatic breast cancer clinical trials and if participating in one would benefit you.
Before beginning treatment, it’s essential to take the time to discuss what to expect from each type of recommended treatment with your breast cancer specialist. Remember that your cancer care team is there to help you make good decisions about your treatment, so don’t be afraid to ask questions so you can understand as much as possible.
Questions to Ask Your Oncologist After a Metastatic Breast Cancer Diagnosis
Understanding your metastatic breast cancer diagnosis can be very empowering. While you probably already learned several things along the way during your first round of treatment, this situation is different. Knowing the details surrounding your specific diagnosis and recommended treatment goes a long way when it comes to being in control and making informed decisions about your care.
As you consider your options, you might want to ask your breast cancer doctor some of these questions:
- Based on the location of my cancer, what kind of prognosis can I expect? Can it be improved in any way?
- What tests are needed before you can create a treatment plan?
- Do I have a specific gene mutation that can be treated?
- What are the goals of the recommended treatment(s)?
- Do I need additional surgery?
- Would I benefit from a clinical trial if I’m eligible?
- What are the risks and side effects of my treatment plan?
- How long until I need to decide on my treatment plan?
- Should I get a second opinion?
- How do you know if the treatment is working? What happens if it doesn’t?
Taking notes during your appointments is a good way to ensure you don’t miss important information. You might want to start a notebook. Be sure to jot down any questions you have for your oncologist and use it to take notes at each of your appointments. It also helps to bring a friend or family member along for support.
Maintaining Self-Care While Living with Metastatic Breast Cancer
As someone with metastatic breast cancer, you’ll need to keep up with cancer treatments. While those are important, it’s also important that you address your other physical and emotional needs. Take time to talk with your cancer care team about maintaining self-care. They can provide helpful resources, including information on nutrition and exercise, stress management, support groups, approved complementary therapies that can help improve your quality of life, and more.
NYOH provides Metastatic Breast Cancer Care Throughout the Capital District
New York Oncology Hematology offers the latest breast cancer treatments in the Albany area. Whether or not you received your care with our team initially, we are available to provide a recommended treatment plan for metastatic breast cancer. One of our breast cancer specialists will review all of the information available about your diagnosis, create an individualized treatment plan, and address any questions you may have about the best next steps.
