Understanding metastatic breast cancer

What to do if cancer comes back

Health Monitor Staff
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Watching your child receive her diploma. Marking a special birthday. Celebrating an anniversary. Today, it’s more possible than ever to reach such milestones—even after being diagnosed with metastatic breast cancer (the spread of your cancer beyond the breast to distant organs and tissues).

Here’s the thing to keep top of mind: While your cancer may no longer be beatable, it is highly treatable. In fact, your doctor has a wider range of treatment options than ever before. More than 150,000 women in the U.S. are now living with metastatic breast cancer, according to the Metastatic Breast Cancer Network—and that’s heartening proof of how far we’ve come.

How does breast cancer metastasize?
Cells break off from the primary cancer in the breast and travel through the bloodstream or the lymphatic system to other parts of the body. Breast cancer most commonly spreads to the bones, the liver, the lungs or the brain. Any place where these cancer cells settle is called a metastasis.

Who gets metastatic breast cancer?
Most metastatic breast cancer patients are women. And while 61 is the median age at diagnosis, those in their 20s and in their 80s can get it, too. In some cases, women are diagnosed with breast cancer and go through treatment only to find later on that their cancer has recurred elsewhere. Others learn with their initial diagnosis that they have stage IV breast cancer.

How is metastatic breast cancer treated?
When deciding which of many treatments is best for you, your healthcare team will consider factors such as your age and general health, the type of cancer you have, its location and how extensively it has spread. Here is a look at the treatment options.

  • Hormone therapy may be used if your cancer is estrogen- or progesterone-receptor positive. Therapies include antiestrogen medications known as SERMs that stop cancer cells from getting estrogen, aromatase inhibitors that stop or inhibit estrogen from being produced, and ovarian treatments that stop the ovaries from producing estrogen. Hormone therapy is often used in patients whose cancer has spread to the bone or soft tissue.
  • Targeted therapy may be used if your cancer has an excess of a special receptor on its surface. The monoclonal antibody trastuzumab, for example, targets cancers that are HER2+.
  • Chemotherapy may be used if hormone therapies are not appropriate for you or if they’ve been used and no longer control your cancer. Chemo can shrink tumors, slow the spread of cancer and control symptoms.
  • Radiation therapy can target tumors, treat bone pain and spinal compression, relieve pain and swelling, or be used to induce menopause.
  • Surgery might be used to remove a tumor or to treat or prevent a bone fracture or spinal compression.

At any point, your doctor may prescribe a single therapy or a combination of therapies. You may need additional therapy to treat bone mets. With so many options, it pays to ensure your current plan is the best choice for you—and that each of your moments is the best it can be.

November 2014