Metastatic Breast Cancer

Metastatic breast cancer is when the cancer cells metastasize (spread) from your breast to other areas of your body. Metastatic breast cancer is also called stage IV (4) breast cancer and is the most advanced stage of breast cancer.

Metastatic breast cancer can occur:

• When you are first diagnosed but the cancer has already spread to other areas of the body, called de novo metastatic breast cancer.
• More commonly, after you have had treatment for your first breast cancer diagnosis. This can happen even years later. This is also called distant recurrence.

Often, metastatic breast cancer happens when not all the cancer cells were destroyed (killed) during the original treatment. Some cancer cells may not be able to be seen on imaging. They stay hidden for some amount of time and then begin to grow and spread again. There is nothing you can do to prevent this from happening and is not caused by anything you did.

Where does breast cancer metastasize?

The most common areas of breast cancer metastasis are the:

• Lung.
• Liver.
• Bones.
• Brain.

Am I at risk for metastatic breast cancer?

Your risk of metastasis after breast cancer treatment depends on a few factors. These include:

• The characteristics (type) of cancer cells.
• The stage of your cancer when you were first diagnosed.
• The treatments for your first breast cancer diagnosis.

What are the symptoms of metastatic breast cancer?

Your symptoms depend on where your metastases are and may include bone pain, cough, chest pain, headache, seizures, nausea, vomiting, loss of appetite, and fatigue.

How is metastatic breast cancer diagnosed?

If you have symptoms of metastatic breast cancer, your provider may want you to have one or more tests done. They may include:

• Blood test: CBC (complete blood count).
• Imaging test: CT (Computed Tomography) scan, MRI (Magnetic Resonance Imaging), PET (Positron Emission Tomography) scan, X-ray, Ultrasound, or bone scan.
• Biopsy: remove and test the tissue in the area being looked at.
• Bronchoscopy: can be used to look at the inside of your lungs.

How is metastatic breast cancer treated?

In most cases, systemic therapy, drugs that treat your entire body, are used for treatment. This can help shrink tumors, slow their growth, ease symptoms, and improve quality of life. It is common for more than one type of treatment to be used because treatments can stop working or the side effects can increase. Possible treatments may be used:

• Chemotherapy.
• Immunotherapy.
• Hormone therapy.
• Targeted therapy.

Surgery and radiation are less likely to be used to treat metastatic breast cancer. Once the cancer has spread, treating the entire body is more common.

In addition to treatment try to eat healthy foods, exercise regularly, and manage your stress. Living with metastatic breast cancer can be difficult and confusing. It can cause sadness, anger, and anxiety. It may be helpful to talk with friends, family, support groups, or your care team.