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Metastatic breast cancer- Signs, prognosis, and management options

Metastatic breast cancer- Signs, prognosis, and management options

Metastatic breast cancer (MBC), a stage 4 cancer, occurs when cancer cells travel beyond the breast and gradually spread to other parts, such as the bones, liver, lungs, or brain. Diagnosing this condition can be complex. Fortunately, timely treatment and care can help individuals manage the condition. Knowing about the common symptoms, systemic treatment options, and prognosis can further help caregivers and those with MBC reduce treatment-related discomfort. 

What “metastatic” or stage 4 means

Metastasis is a process that causes cancer cells to break away from the original tumor in the breast. The cancer cells travel through the lymphatic system or the bloodstream to form new tumors in other organs. The cells mostly spread to the bones, liver, lungs, and brain. However, healthcare providers call it breast cancer regardless of the tumor’s new location. This means if the breast cancer has moved to the lungs, it is treated with therapies that are specific to manage breast cells. 

De Novo vs. Recurrent Metastatic Breast Cancer

An initial diagnosis of breast cancer can happen in different ways. In some cases, the cancer is first diagnosed when it is already in stage 4, also referred to as de novo metastatic breast cancer. In other cases, recurrent metastatic disease occurs when cancer relapses and is found in another part of the body several months or years after successful treatment of an earlier stage of the disease.

Common symptoms of metastatic breast cancer

Symptoms 

Some of the most common signs of metastatic breast cancer depend on where the cells have traveled in the body. If the disease reaches the bones, it can cause chronic aching, persistent back pain that does not subside with rest, or unexpected fractures from minor activities. Meanwhile, if the lungs are affected, a person may experience symptoms like a dry cough, discomfort in the chest, or persistent shortness of breath.

If the liver is affected by cancer, there can be abdominal swelling, discomfort in the upper right side, or a yellowing of the skin known as jaundice. When cancer spreads to the brain, symptoms can include frequent headaches, changes in vision, or sudden difficulties with coordination and balance.

Consult a healthcare professional

When individuals notice any new or worsening physical symptoms that last for several days, they should consult a healthcare practitioner. Seeking prompt medical attention can help determine whether the symptoms are related to cancer or are side effects of ongoing treatment. For this, individuals can consider keeping a daily diary to track when the symptoms occur and their intensity. Reviewing these dairy entries can provide doctors with valuable information during routine checkups, allowing them to make necessary adjustments to the treatment plan to alleviate discomfort and improve overall physical well-being.

Treatment approaches for stage 4 breast cancer

Overall goals of treatment

The main goal of most treatment plans for metastatic cancer is managing the symptoms and controlling the growth of the tumors. Instead of looking for a one-time cure, doctors come up with treatment plans that involve ongoing monitoring and care. This is why most treatments are flexible and likely to change over time, allowing the care team to adjust strategies as the body’s needs change. 

Systemic therapies 

Since stage 4 cancer is usually present in several areas, systemic therapies are used for managing the disease. These are administered through the bloodstream to reach the affected cells throughout the body. Common treatment options include hormone therapies, targeted therapies, and immunotherapies. The type of treatment to be administered is determined based on the specific aspects of the tumor, such as its HER2 status and hormone receptor markers.

Local treatments for specific problem areas

While systemic therapy is administered throughout the body, local treatments, such as radiation, are used to target specific areas that cause discomfort. These can include stabilizing a weakened bone and shrinking a tumor that might be pressing against a nerve. Such treatments are usually done to provide immediate pain relief.

Advanced breast cancer prognosis 

The prognosis of advanced breast cancer differs from person to person. In most cases, it depends on where the cancer cells are located and how the tumor behaves. Often, factors like the overall health of the person and how well the body responds to treatment also matter. With modern healthcare being improved with advanced technology over the years, individuals with MBC can now lead an active life for years after a stage 4 diagnosis. l

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