Life Expectancy of Women With Metastatic Breast Cancer

Metastatic breast cancer is also called stage IV or advanced breast cancer, in which the cancer has spread beyond the breast and adjacent lymph nodes to other parts of the body such as the bones, lungs, liver, or brain.

Remote recurrence occurs when metastatic breast cancer develops months or years after a person has finished therapy for early or locally advanced breast cancer.

Only 6% of women and 9% of men in the U.S. are diagnosed with de novo metastatic breast cancer, which refers to breast cancer that is already metastatic at the time of diagnosis.

Symptoms of metastatic breast cancer are tricky because they vary depending on where the metastasis occurs. Some symptoms may be side effects of cancer treatment or a sign of stress or depression associated with the disease. It is crucial to investigate the cause.

Common symptoms of metastatic breast cancer include:

• Severe pain and swelling in the bones or the joints
• Weak bones (easily fractured)
• Nausea and vomiting
• Jaundice
• Abdominal pain
• Loss of appetite
• Chest pain
• Chronic cough
• Seizures
• Headache
• Loss of balance
• Confusion
• Vision changes
• Behavioral changes

While there is no cure for metastatic breast cancer, there are several treatment options that can help patients live longer lives. Treatment options depend on where the cancer has spread, features of the tumor (hormone receptor or HER2 status), and past therapies:

• Hormonal therapy: Tamoxifen, fulvestrant, or aromatase inhibitors are used to stop or delay the progression of hormone receptor-positive or HR+ metastatic breast cancer.
• Immunotherapy: Trastuzumab, pertuzumab, and pembrolizumab are examples of antibodies that can be used to boost the immune system to fight cancer.
• Chemotherapy: Doxorubicin, capecitabine, and paclitaxel may be administered alone or in combination with other treatments to treat metastatic breast cancer that is growing quickly or is present in other organs.
• Targeted therapy: Targeted therapy involves using drugs that target specific features of cancer cells, such as proteins that cause cancer to spread uncontrollably. While chemotherapy drugs cannot differentiate between cancerous and noncancerous cells and thus kill both, targeted therapies are less likely to harm normal cells. FDA-approved targeted treatments for metastatic breast cancer include:
• PARP-inhibitors: Olaparib and talozoparib target an important enzyme involved in DNA repair.
• CDK4/6-inhibitors: Palbociclib and abemaciclib can interrupt specific enzymes to slow or stop cancer cells from growing.

While surgery is a possibility, it is difficult to eliminate all cancer cells in metastatic breast cancer. Some doctors may propose targeted surgery and radiation to relieve pain or symptoms. Furthermore, although other localized therapies, such as radiation therapy, ablation, or chemotherapy, are not commonly used to treat metastatic breast cancer, they may be used in certain circumstances, such as the following:

• Tumors press on critical areas of the brain or spinal cord
• Bone metastases weaken the bone to the point of fracture
• Lung lesions make breathing difficult
• Tumors interfere with normal liver function