Advances in Metastatic Breast Cancer Care

While no one wants their breast cancer to return or spread after initial diagnosis and treatment, improved treatment options for metastatic breast cancer are helping patients live less disrupted, longer, and more rewarding lives.

What Is Metastatic Breast Cancer?

Breast cancer is the most commonly diagnosed cancer in women in the U.S. According to the American Cancer Society breast cancer accounts for 30% of all new cancer cases in women. The majority of women with newly diagnosed breast cancer have cancer limited to the breast and lymph nodes and are potentially cancer-free after appropriate treatment. Only 10% of breast cancer patients have breast cancer spread to other sites (metastatic) at the time of initial diagnosis. Metastatic breast cancer is diagnosed when breast cancer spreads to places other than the breast, such as the bones, lymph nodes, lung, liver, and rarely the brain. Women who have been treated for early-stage breast cancer should report new or worsening symptoms to their oncologist. For women with early-stage invasive breast cancer there are two parts of treatment:

1. Surgically removing the cancer
2. Administering treatment to prevent future whole-body recurrence.

What Are the Symptoms?

Symptoms of metastatic breast cancer include:

• Pain or swelling in lymph nodes
• Unexplained musculoskeletal (bones, joints, ligaments, tendons, muscles) pain that persists
• Shortness of breath
• Cough
• Unexplained weight loss
• Abdominal pain and bloating

Patients with these symptoms usually undergo diagnostic imaging that may include a PET scan, CT scans or MRIs. A biopsy is indicated if any significant abnormalities are found.

Treatment Advances

While there is currently no cure, advances in treatment options and medications help patients live longer, fuller lives while being treated. Treatments can shrink the cancer or slow its growth – sometimes for many years. Further, advances in care have increased the arsenal of weapons available to health care providers. It’s common for different treatments to be used alone, in combination or in sequence. When one treatment stops working, another can be tried, depending upon previous treatments, location of the cancer, the patient's age, general health, and desire to continue treatment.

How Is Metastatic Breast Cancer Treated?

The most common treatments for are systemic medications, including chemotherapy, hormonal therapy, targeted drugs, immunotherapy and bone-strengthening medications. Individualized care and treatment are based on the cancer characteristics, such as hormone sensitivity, HER 2 status (a protein that helps breast cancer cells grow quickly), sites of disease, and patient overall health status. Numerous new targeted drugs have been approved based on clinical trials that have resulted in improved quality of life and longer survival for women with metastatic breast cancer. The majority of women with early-stage breast cancer will be treated first with surgery. In some circumstances, chemotherapy will be administered before surgery. Radiation is often administered after surgery to prevent cancer from recurring in the breast. Whole-body treatment with hormone therapy (e.g., anastrozole, tamoxifen) with or without chemotherapy is given to women with hormone sensitive breast cancer to reduce the whole-body risk of recurrent or metastatic breast cancer. Chemotherapy is often indicated for a woman whose cancer is not hormone sensitive or is HER 2 positive. Recent advances in local and systemic treatment have markedly improved survival. Advances now decrease the risk of metastatic recurrence after treatment for early-stage breast cancer. If you are a current breast cancer patient or a survivor experiencing unusual discomfort or other symptoms, call your health care provider.