The survival rate is highly individual
When breast cancer develops the ability to spread to other organs in the body – most commonly the liver, lung, bone, soft tissues or brain – it’s called metastatic disease.
These new areas of disease, however, are still breast cancer, and are treated as breast cancer. For example, breast cancer that has spread to your liver is not liver cancer but considered metastatic breast cancer. Your cancer care team will use breast cancer therapy to treat metastatic breast cancer regardless of the site of involvement.
“Metastatic breast cancer is treatable but not curable, explains Sheheryar Kabraji, BMBCH, Chief of Breast Medicine at Roswell Park Comprehensive Cancer Center.
While all types of can become metastatic, and the risk of metastasis increases with tumor stage, even early-stage tumors have a small risk of metastasizing, he adds.
“Most patients will be on treatment for their metastatic breast cancer lifelong. But recent advances in cancer therapy and supportive care have improved both the prognosis of this disease and women’s quality of life during treatment."
Research estimates that more than 150,000 women in the United States are currently living with metastatic breast cancer. In the U.S., only about 6 % of women are found to already have metastatic disease at the time of their diagnosis, called stage 4 disease. In most women with metastatic breast cancer, the metastases developed months to years after they were initially treated for early-stage breast cancer.
Metastatic breast cancer symptoms
Metastatic breast cancer can produce different symptoms depending on the organ to which it has spread. Your oncologist will choose therapy that addresses these symptoms, in addition to prescribing pain and other medications. For example, Gamma Knife radiosurgery may be used to treat breast cancer lesions involving the brain. Other radiation therapy treatments and bone-strengthening drugs can improve pain arising from bone metastasis and prevent complications.
Treatment for metastatic breast cancer
The survival rate for metastatic breast cancer is highly individual and depends on how the cancer responds to treatment. The average survival for metastatic breast cancer is around two years, but over a quarter of women with the disease breast cancer are now living with the disease over five years from diagnosis.
“Treatment for metastatic breast cancer involves addressing cancer-related symptoms to improve function and help extend the length of life, and improving the quality of life,” says Dr. Kabraji.
Treatment is based on many varied factors, including:
- Tumor characteristics: Cancers with hormone receptors (ER/PR positive tumors) are usually treated with anti-estrogen therapy, sometimes called hormone therapy, with or without targeted therapy.
- Past breast cancer treatments: The previous treatments a woman has received for her breast cancer will determine, in part, which treatments are available or chosen for her metastatic disease. It is important to have a biopsy to assess the presence of hormone receptors on the metastatic breast cancer cells, because metastatic breast cancer does not always have the same profile as the original tumor. HER2 expression is also important to determine, as the available treatments for targeting the HER2 receptor have grown in number and efficacy.
“Breast cancer that does not express estrogen or HER2 is known as ‘triple negative’ breast cancer and is typically treated with chemotherapy and, often, immunotherapy,” Dr. Kabraji says.
Clinical trials offer access to the newest approaches
The best care of patients with metastatic breast cancer is often in a clinical trial. A clinical trial is a scientific study that evaluates a drug for safety, efficacy or both.
“The benefit of being in a clinical trial is access to new treatments before they become widely available. However, because these treatments are still being tested, the benefit is uncertain and there may be risk,” advises Dr. Kabraji.
Several novel options are available through clinical trials at Roswell Park for patients with metastatic breast cancer. Always ask your doctor about whether a clinical trial is right for you.
Supportive care to improve quality of life
In addition to anti-cancer treatments, women with metastatic breast cancer should take advantage of additional specialists who work to improve their quality of life during treatment. Our supportive care specialists, such as experts in pain and palliative care, psychologists and physical therapists can help to maintain and improve a patient’s function, well-being and independence during cancer therapy.
