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Metastatic Breast Cancer

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Metastatic Breast Cancer

For any woman, the diagnosis of breast cancer can be devastating. For those who will hear a diagnosis of metastatic or stage 4 breast cancer it can be downright terrifying. At this stage in any cancer, the condition is considered to be incurable. It is not, however, hopeless. Women with this diagnosis who understand what metastatic cancer is, how it can be treated, and what the odds are stand an excellent chance of extending their doctor’s life expectancy prognosis.

What is Metastatic Cancer?
Metastatic cancer refers to any cancer that has moved from its point of origin to other parts of the body. At this stage, cells from the original tumor have developed new properties including those that allow them to migrate to new locations and grow into new tumors. Breast cancer cells usually metastasize to the lungs, bones, brain, liver, and lymph nodes. When cancer cells travel to the lymph nodes under the arm, but no further, it is not considered metastatic and is still curable. When they spread beyond the lymph nodes, the condition becomes metastatic or stage 4 breast cancer.

Metastasis is influenced by anatomy. The cells travel through the blood stream, so the pattern of flow from the original tumor often determines where the next tumor will form. Other considerations include the types of receptors have formed on the cancerous cells and the adherents on different target organs.

What are Symptoms of Metastatic Breast Cancer?
The symptoms of metastasized breast cancer depend upon where the new tumor has formed. If it is in the bone, which is the most common secondary location for a breast cancer tumor, symptoms include pain that becomes progressively worse, redness in the skin over the affected bone, and swelling. A metastasized brain tumor will lead to worsening headaches, seizures, blurred vision, or personality changes. In the liver, symptoms are jaundice, loss of appetite, vomiting, and abdominal pain. A chronic cough, chest pain, and breathlessness are symptomatic of tumors in the lungs. In addition to specific symptoms, a woman with metastasized breast cancer may experience weight loss, decreased appetite, fatigue, and general malaise.

How is Metastatic Breast Cancer Diagnosed?
Most testing for metastatic breast cancer is done on patients who have a recurrence of breast cancer. Doctors may order bone scans, CAT scans, MRIs, chest X-rays, and blood tests to detect cancerous cells or abnormalities in other parts of the body. The blood test for breast cancer looks for markers called CEA and CA 15-3. CEA is a protein that occurs in cancerous cells, but elevated levels can also indicate benign conditions. When a doctor finds high levels of markers in a woman’s blood, they will then order more invasive tests and scans. CA 15-3 is a cancer cell antigen. Measuring levels of this molecule is not useful for detecting an early stage of breast cancer, but can indicate metastasized cells.

Are There Treatments for Metastatic Breast Cancer?
Women who are in this last stage of breast cancer need not lose all hope. There are several treatment options that can alleviate symptoms and extend the life of the patient beyond what is otherwise expected. With metastatic breast cancer, as opposed to earlier stages, treatments are not very aggressive, rather they aim to bring comfort to the patient.

Therapy with hormones, for instance, has minimal side effects and can control metastasis fairly effectively. Hormone treatment works for women who have estrogen-positive cancer. These are cancers that feed on estrogen and treatment is designed to cut off the tumor’s supply.

Chemotherapy for metastatic breast cancer is more aggressive than hormone therapy, but still less so than chemotherapy used in early-stage cancers. Doctors will most likely use a single chemotherapy agent rather than a combination of drugs. Chemotherapy involves using a drug that kills tumor cells. They also kill healthy cells which results in very serious and uncomfortable side effects. For metastatic treatment, the goal is to use drugs to control the metastasis while keeping side effects at a minimum.

For women who have developed bone cancer, a newer class of drugs called bisphosphonates has been found to slow the breakdown of bone tissue. Prior to these drugs, women with bone cancer suffered from fractures and pain as their bones deteriorated. The drugs, while they cannot halt the cancer, stop the deterioration and resulting pain.

While living with metastatic breast cancer means being at the end of life, it does not have to cause significant pain and discomfort any longer. With the right care and selected treatments, women in stage 4 can potentially live for several more years with a good quality of life.

Related Articles: 
Breast Cancer Pathophysiology
Invasive Lobular Carcinoma
The Different Types of Breast Cancer

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