Understanding Metastatic Breast Cancer
Dr. Gina Lynem-Walker
| 4 min read
Dr. Gina Lynem-Walker, MD, is a quality medical director for utilization management at Blue Cross Blue Shield of Michigan. She is an internal medicine physician with experience in utilization management, care management and disease management, and is a volunteer faculty member at Wayne State University Medical School. She is married with two children, and enjoys gardening, reading, crafts, music, community service and travel.
Metastatic breast cancer is the most advanced stage of breast cancer. About one in eight American women will develop breast cancer in their lives, and about one in three of those cases will become metastatic. Men can also be affected by metastatic breast cancer.
Also classified as stage IV breast cancer, metastatic breast cancer occurs when cancer spreads from a person’s breast to other parts of their body. The area of the spread is called a “metastasis.” This type of cancer can affect people who had breast cancer without seeking treatment, those with aggressive types of breast cancer – like triple-negative breast cancer – and patients whose screenings did not detect breast cancer.
The good news is, the five-year survival rate of women diagnosed with metastatic breast cancer is increasing, especially among women aged 15 to 39, according to the National Library of Medicine. About 15% of metastatic breast cancer cases can be detected at the time of diagnosis. That’s why knowing the signs and symptoms – as well as learning about screening and treatment options – can save lives.
Signs and symptoms of metastatic breast cancer
When breast cancer metastasizes, it usually spreads to the lungs, liver, bones or brain, so symptoms may vary. According to the National Breast Cancer Foundation, metastasis to the bone – the most common spreading place – may lead to:
- Bones that are more easily fractured or broken (unrelated to osteoporosis)
- Severe, progressive pain
- Swelling
Metastasis to the brain may cause:
- Behavioral changes or personality changes
- Persistent headaches or pressure to the head
- Seizures
- Vision disturbances
- Vomiting or nausea
Metastasis to the liver may cause:
- Abnormally high enzymes in the liver
- Abdominal pain, appetite loss, nausea, and vomiting
- Itchy skin or rash
- Jaundice
Metastasis to the lungs may cause:
- Abnormal chest X-ray
- Chest pain
- Chronic cough
Other nonspecific systemic symptoms of metastatic breast cancer can include:
- Fatigue
- Poor appetite
- Weight loss
These final three symptoms can sometimes be caused by medication or depression. It’s important for all symptoms to be reported to an individual’s primary care provider.
Metastatic breast cancer screening and diagnosis
Though serious, a metastatic breast cancer diagnosis does not always mean the condition is terminal. A primary care provider may recommend blood tests or imaging tests to diagnose it. Some people are at higher risk for metastatic breast cancer once their cancer treatment is finished.
The risk depends on factors such as tumor characteristics, the stage at which a person was initially diagnosed, and the type of treatment received. Routine evaluations with a primary care provider or cancer specialist can play a major role in diagnosing potential cancer recurrence. So, in addition to routine checkups, it’s important to maintain a healthy weight and lifestyle, and avoid smoking and consuming alcohol to help reduce the chance of cancer recurrence.
Treatment options for metastatic breast cancer
The body’s response to metastatic breast cancer treatment varies by patient, but most can slow the spread of cancer and/or minimize the impact of symptoms by seeking the following treatment methods:
- Chemotherapy: Can be utilized to suppress and stop the growth of the cancer and kill the cancer cells. It can also be helpful for those with multiple areas of spreading cancer.
- Hormone therapy (endocrine therapy): Uses hormones to address breast cancer cells that are sensitive to estrogen or other hormones.
- Immunotherapy: Uses the body’s immune system to identify the cancer cells as invaders and fight them.
- Radiation therapy: Uses high-energy X-rays or other particles to kill cancer cells.
- Surgery: This involves removing the tumor and nearby margins.
- Targeted drug therapy: Uses medicines that are directed at target proteins on breast cancer cells that allow them to grow, spread and live longer. Targeted drugs aim to destroy cancer cells or slow down their growth.
The five-year relative survival rate for metastatic breast cancer in the United States is 30% among women and 19% among men. There is no cure for metastatic breast cancer, however it is important to remember that breast cancer is treatable at any stage. Technology and treatment methods continue to improve and have allowed metastatic breast cancer patients to have a longer, better quality of life.
Gina Lynem-Walker, M.D., is an associate medical director at Blue Cross Blue Shield of Michigan. For more health news and information, visit MIBluesPerspectives.com.
Photo credit: Getty Images
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