Metastatic breast cancer

Learning that you have metastatic breast cancer, also known as Stage 4 breast cancer, can be overwhelming. Whether you or a loved one is facing this diagnosis, it's important to have clear, accessible information.

Our cancer specialists at Advocate Cancer Institute are here to support you and your loved ones as you navigate the challenges of metastatic breast cancer treatment. From the most advanced treatment options to access to clinical trials, we offer the most comprehensive cancer care in Illinois.

Risk factors of metastatic breast cancer

Certain factors may increase your risk of developing metastatic breast cancer. These include:

• Previous breast cancer diagnosis: If you've had breast cancer before, there's a higher chance it could return and spread.
• Age: The risk of breast cancer increases with age, particularly after menopause.
• Genetic factors: Mutations in genes like BRCA1 and BRCA2 can significantly increase your risk.
• Family history: A family history of breast cancer or other cancers can indicate a higher risk.
• Lifestyle factors: Factors such as obesity, alcohol consumption and lack of physical activity can contribute to the risk.

While breast cancer is much more common in women, men can also get it.

Regular self-exams are a great way to keep on top of your breast health and notice with something isn’t quite right. Getting an annual mammogram is vital for early detection of a tumor before it has spread.

Stages of breast cancer

When you're diagnosed with breast cancer, your doctor will assign a stage and grade to the tumor. This helps them create a treatment plan personalized to your needs.

Breast cancer stages range from 0 to 4:

• Stage 0: Also known as ductal carcinoma in situ (DCIS), this is non-invasive cancer confined to the ducts or lobules in the breast.
• Stage 1: Early stage, where cancer is small and confined to the breast.
• Stage 2: Larger tumors or cancer that have spread to nearby lymph nodes.
• Stage 3: Cancer that has spread to several nearby lymph nodes or surrounding tissues.
• Stage 4: Also known as metastatic breast cancer, this is when the cancer has spread to distant parts of the body.

Signs of metastatic breast cancer

Recognizing the signs of metastatic breast cancer is crucial for early intervention and improving outcomes. Symptoms can vary depending on where the cancer has spread, but common signs include:

• Bone pain: Persistent pain in the bones, often in the back, hips or ribs.
• Unexplained weight loss: Losing weight without trying.
• Shortness of breath: Difficulty breathing, especially if cancer has spread to the lungs.
• Fatigue: Extreme tiredness that doesn't improve with rest.
• Jaundice: Yellowing of the skin and eyes, which can indicate liver involvement.
• Neurological symptoms: Headaches, seizures or dizziness if cancer has spread to the brain.

If you notice any changes to your health or have any metastatic breast cancer symptoms, schedule an appointment with your doctor.

Diagnosing metastatic breast cancer

Diagnosing metastatic breast cancer involves a combination of physical exams, imaging tests, biopsies and blood tests. This thorough approach helps determine the extent of the spread and determine which areas are affected.

The diagnosis process often begins with a physical examination. Your doctor will check for lumps, assess your symptoms and evaluate your overall health.

Imaging tests are a vital part of diagnosing metastatic breast cancer and detecting where the cancer has spread in your body. Common imaging tests include mammograms, CT scans, an MRI, bone scans and PET scans.

If imaging studies detect abnormalities in the breast or other areas of your body, a biopsy is necessary to confirm or deny the diagnosis of metastatic cancer. During this procedure, a small sample of tissue is extracted from a suspected metastatic site, either through a thin needle or during a surgical intervention.

Your doctor may also order blood tests, including a complete blood count or liver function tests. Blood tests can also provide insight into the tumor’s progression and response to treatment.

What to do when diagnosed with metastatic breast cancer?

Receiving a diagnosis of metastatic breast cancer can be life changing. Receiving a second opinion from a surgeon who is actively involved in treating your specific type of breast cancer is critical.

The next step is finding an oncologist who specializes in metastatic breast cancer. They can review your treatment options, including breast cancer clinical trials.

Additionally, supportive care services such as counseling, nutrition therapy, palliative care and physical therapy can help address both the impact cancer treatments have on your physical and emotional health.

Is metastatic breast cancer curable?

Currently, metastatic breast cancer is not considered curable. However, it is treatable. Advances in medicine have made it possible to manage the disease for many years. The focus is on controlling the spread, alleviating symptoms and maintaining the best quality of life possible.

Metastatic breast cancer treatment

Some treatment options available to you or your loved ones include:

• Chemotherapy: Chemotherapy is employed for more aggressive cancers and usually given before surgery to shrink the tumor and slow the spread.
• Surgery: Metastatic breast cancer often spreads to more than one area, so doctors typically don’t recommend surgery. Surgery may be recommended to target specific symptoms. For example, if a tumor is on your kidney, they may perform surgery to remove tumors on your kidney.
• Radiation therapy: Following surgery, radiation therapy may be administered to eliminate any residual cancer cells in the breast and reduce the risk of recurrence.
• Targeted therapy: Certain cancers express specific molecular targets that can be addressed with targeted medications. These drugs aim to disrupt the formation of new blood vessels, thereby slowing tumor growth.
• Hormone therapy: Hormone therapy is used to block or reduce estrogen that is feeding cancer cells, which allows them to grow faster.

Is metastatic breast cancer treated with surgery?

They may suggest surgery to ease specific symptoms. For example, if there’s breast cancer in your liver, they may do surgery to remove tumors that keep your liver from working as it should.