Metastatic breast cancer can be a daunting diagnosis, but the prognosis has improved somewhat with advances in treatment.
Also known as stage 4 breast cancer, metastatic cancer is defined as the spread of disease beyond the local breast and nearby lymph nodes. More than 150,000 individuals in the United States are living with a diagnosis of metastatic breast cancer, which accounts for the majority of breast cancer deaths. According to the American Cancer Society, more than 43,000 people, mostly women, died from breast cancer in 2022.
This advanced stage of breast cancer can occur years after an original early-stage breast cancer or it may be the first presentation of breast cancer. Black women are more likely to be diagnosed with later stages of breast cancer and at a younger age. However, the majority of patients living with metastatic breast cancer were initially diagnosed with early-stage breast cancer and took all the right steps to reduce their risk of recurrence.
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Metastatic breast cancer symptoms
Breast tumor cells originating from primary breast tumor or regional lymph nodes can spread to any other part of the body, including:
- Brain
- Lungs
- Liver
- Bones
- Ovaries
- Skin
Symptoms related to metastatic breast cancer are primarily dependent on the location of the metastasis, and then on the chronic medical conditions and general health status of the patient experiencing the symptoms.
There are a number of symptom management strategies that can be used to mitigate these toxicities. These may include multidisciplinary collaborations with other specialties, including:
- Psychosocial oncology
- Palliative care
- Oncology rehabilitation
Better quality of life is one of the key goals for the management of metastatic breast cancer that is equally shared by patients, caregivers and clinicians.
Metastatic breast cancer treatment
Breast cancer consists of three major tumor subtypes categorized according to estrogen or progesterone receptor expression (hormone receptor-positive) or ERBB2 (HER2) gene amplification. The three subtypes have distinct risk profiles and treatment strategies.
In metastatic hormone receptor-positive breast cancer, early treatment should be endocrine therapy-based, typically with the incorporation of