The American Cancer Society estimates that 281,550 women will be diagnosed with breast cancer this year, and about 6% of those will be diagnosed with metastatic disease. While metastatic cancer is the most advanced stage of breast cancer, this diagnosis is not hopeless thanks to advancements in therapies that are enabling many individuals to live longer and enjoy a better quality of life.
So, what exactly is metastatic breast cancer, and what can a person expect if they receive this diagnosis?
What Is Metastatic Breast Cancer?
Metastatic breast cancer occurs when breast cancer cells break away from the primary tumor and travel through the bloodstream or the lymph system to reach other parts of the body, such as the liver, lungs, brain or bones, and can form tumors there.
In some individuals, breast cancer has already metastasized, or spread, by the time of diagnosis — sometimes referred to as de novo metastatic breast cancer. In other individuals, cancer that was in the breast comes back in other parts of the body after treatment, called metastatic breast cancer or distant recurrence.
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Likelihood of Being Diagnosed With Metastatic Breast Cancer
Over a woman’s lifetime, there’s a 1 in 8 chance she will get early stage breast cancer. For men, the lifetime risk is about 1 in 1,000.
According to the ACS, at the time of diagnosis approximately 64% of breast cancer patients have local-stage breast cancer (has not spread outside the breast), 27% have regional stage (spread to the nearby structures or lymph nodes) and 6% have metastatic disease (spread to distant parts of the body). BreastCancer.org notes that nearly 30% of women who are diagnosed with early-stage breast cancer eventually develop metastatic disease.
Symptoms of Breast Cancer
Warning signs of early breast cancer include:
— Lump in the breast.
— Abnormal thickening of breast tissue.
— Lump under the arm.
— Red or scaly skin on the breast.
— Change in the nipple (such as discharge or inversion).
— Dimpling of the skin.
Symptoms of metastatic breast cancer vary due to the location of cancer but may include:
— Intense bone pain.
— Numbness or weakness.
— Respiratory issues (difficulty breathing, shortness of breath).
— Neurological issues (headaches, seizures, vision problems).
Consult your physician if you have symptoms for more than two weeks.
[READ: What Are the Types of Biopsy for Breast Cancer?]
Diagnosis of Metastatic Breast Cancer
There are a variety of diagnostic tests, including:
— Biopsy of the metastatic tumor site is routinely done at the time of diagnosis or soon after to help confirm diagnosis and inform treatment.
— Computed tomography, or CT, scan looks for tumors in organs.
— Bone scan looks for cancer that spread to the bones by using a radioactive tracer to look at the inside of bones.
— Positron emission tomography, or PET, or FDG PET-CT scan looks for cancer using excess glucose in organs, bones and soft tissues. A PET scan is usually combined with a CT scan to create pictures of organs and tissues inside the body. Another new type of PET, called a FES PET, may be recommended to identify estrogen-receptor positive breast cancer in the body.
— Magnetic resonance imaging, or MRI, looks at a particular body site in detail.
— Serum chemistry blood test looks at minerals in the blood and specialized proteins that can be abnormal if cancer has spread.
— Complete blood count, or CBC, measures the number of different types of cells by testing a sample of blood to make sure the bone marrow is working well.
— Blood tumor marker test monitors the growth of metastatic disease by looking for tumor proteins found in a person’s blood.
— Genetic testing is done on any cell in the body that may have a mutation, suggesting a hereditary condition.
Can Genetic Testing Detect Metastatic Breast Cancer?
Genetic testing can help women understand if they are at higher risk of developing breast cancer. While it is not currently used for the diagnosis or detection of metastatic breast cancer specifically, the team at Seattle Cancer Care Alliance is optimistic that in the future, there will be ways to detect and treat early metastatic disease before it develops into incurable metastatic breast cancer.
Treatment for Metastatic Breast Cancer
Metastatic breast cancer is not curable, but it is treatable — often for long periods of time.
A tissue diagnosis (a needle sample of a metastatic site) is recommended to evaluate potential targets for therapy. Genetic testing of the blood (germline) and the tumor (somatic) may also influence treatment options.
Treatment will mostly be drug based, using endocrine (hormone) therapies, targeted therapies and chemotherapy to eliminate cancer cells. Surgery or radiation therapy may also be recommended, mainly to relieve symptoms. For example, radiation therapy can help relieve pain by shrinking tumors in bones.
Many individuals with metastatic disease receive treatment in clinical studies that offer access to new interventions. To determine if participation in a clinical study could be an option, speak with your oncologist.
Support and care to reduce symptoms and enhance quality of life are important. Recognizing that patients with metastatic cancer have unique perspectives, care expectations and treatment goals, SCCA created the Advanced Stage Support Information Symptoms Trials, or ASSIST, program to provide supportive care in coordination with clinical treatment.
[READ: Stories from Breast Cancer Survivors]
Prognosis of Metastatic Breast Cancer?
Recent data show women with metastatic breast cancer are living longer with better quality of life than ever before due to advances in targeted therapies.
The ACS states the five-year relative survival rate for patients diagnosed with metastatic breast cancer is 28%. However, an individual’s survival is more difficult to predict and can be influenced by several factors including the specific type of breast cancer, location of metastases, presence of other health issues and age. New treatments for metastatic breast cancer are improving survival and many patients live many years with breast cancer.
What Can Be Done to Decrease Your Risk of Developing Metastatic Breast Cancer?
If you’ve been diagnosed with early breast cancer, it is crucial to work with your oncologist to complete the recommended adjuvant therapy (therapy given after the primary treatment), stay physically active, try to eat a healthy diet loaded with fruits and vegetables and avoid high-fat and processed foods. It is also important to keep follow-up visits with the treatment team and report any new worrisome or worsening symptoms.
Individuals with a family history of breast, ovarian or other cancers are encouraged to speak with their doctor about genetic testing to determine if they have a gene mutation that places them at higher risk, such as BRCA1, BRCA2 or PALB2.
All women are encouraged to pay attention to what their breasts normally look and feel like, report any changes to their doctor and be screened regularly according to the latest ACS guidelines.
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What Is Metastatic Breast Cancer? originally appeared on usnews.com
