If you've been told you have stage 4, or metastatic, breast cancer, you might be wondering what that means. In simple terms, it means the cancer is no longer contained in the breast area and has spread (metastasized) to another part of your body. While metastatic breast cancer can grow anywhere in the body, it most commonly affects the bones, brain, lungs, or liver.
Although there is no cure for metastatic breast cancer, do not lose hope! Many patients can live longer and fuller lives with the right treatment plan.
Stage IV breast cancer can be an initial diagnosis, called "de novo" metastatic breast cancer, or it can be recurrent breast cancer that appears in another area of the body after going through treatment. When breast cancer recurs, it’s typically because some cancer cells were left behind after the initial breast cancer treatment. These surviving cancer cells may stay inactive or hidden, making them undetectable until they start growing and spreading.
When breast cancer spreads to other areas of the body, such as the bones, it is still considered and treated as breast cancer since that is where the cancer originated. Sometimes, women or men can have a metastasis and no breast mass or tumor is found, but the site of metastasis still comes from the breast.
The symptoms of metastatic breast cancer depend on where the cancer has spread and how much it has grown before being detected. Reach out to your breast cancer oncologist if you are experiencing any symptoms so they can run tests.
General symptoms related to recurrent breast cancer include vomiting, fatigue, or weight loss with no specific reason. Other symptoms depend on the areas where the cancer has spread:
Sometimes, there are no apparent symptoms, but your doctor may notice high enzymes on a liver test or signs of a problem on a follow-up imaging test that leads to a new diagnosis.
Your cancer care team will likely schedule several follow-up appointments after treatment is complete. You’ll likely have a blood test to look for tumor markers during these appointments. If tumor markers are elevated, it could mean cancer is growing again somewhere in the body. In cases like this, more tests, such as a PET scan or MRI, will be done to identify where. Reporting symptoms to your oncologist will help them decide where to look. Elevations of tumor markers do not always mean recurrent cancer.
Don’t skip these appointments, even if you’re feeling good. If cancer starts to grow again, it’s best to find it as soon as possible. Plus, you can discuss any lingering or new side effects during these appointments.
There are several treatments available for patients diagnosed with metastatic breast cancer, several of which are not typically used during the initial treatment process. Treatment options for metastatic breast cancer can include:
Clinical research trials are also an option for some patients if their type and stage of breast cancer match a clinical trial currently recruiting participants. If one is available, your doctor and a research coordinator will discuss possible participation with you.
Metastatic breast cancer isn't typically treated with surgery or radiation therapy because the cancer has spread to areas where these treatments aren't effective. Surgery may not be possible if the cancer is widespread, and radiation is typically used for localized tumors. In some cases, radiation is used to relieve symptoms caused by the distant tumor, such as pain caused by a spot in your bones.
The ultimate goal is to meet your individual needs so that you have the best overall outcome. Your oncology team is the best resource for helping you make informed decisions about your treatment, as they evaluate your case closely to develop a treatment plan.
Understanding your metastatic breast cancer diagnosis can help you feel more in control of your treatment and care. Although you may have already learned a lot during your initial treatment, take time to talk with your breast cancer specialist before beginning treatment so you'll know what to expect. They can also help to address any new questions and concerns you may have.
Here are some things you might want to ask your oncologist about as you consider your options:
Remember to bring a notebook to write down the answers to your questions, and consider bringing a friend or family member along for support.
It is critical to stay on top of your metastatic breast cancer treatments. However, this doesn't mean you should overlook other physical and emotional needs. Your cancer care team can offer suggestions and provide helpful resources. These may include information on nutrition and exercise, stress management, support groups, approved complementary therapies to help improve your quality of life, and more.
The breast cancer doctors at Virginia Oncology Associates provide the most up-to-date methods of treating stage IV metastatic breast cancer. Treatment is available at our cancer centers throughout Virginia and Eastern North Carolina, including Chesapeake, Elizabeth City, NC, Hampton, Newport News, Norfolk, Suffolk (Obici and Harbour View), Virginia Beach, and Williamsburg. Even if you received your initial breast cancer treatment elsewhere, you can access our services close to home.